{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T22:30:18Z","timestamp":1785364218471,"version":"3.55.0"},"reference-count":43,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["401071"],"award-info":[{"award-number":["401071"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the effect of propranolol on myometrial contractions induced by low dose and high dose oxytocin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective ex\u00a0vivo laboratory study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Mount Sinai Hospital, Toronto.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Full\u2010term parturients who underwent elective caesarean deliveries (CD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two models were developed in the organ bath chamber using myometrial samples obtained during CDs: (i) <jats:italic>Labor induction\u2010augmentation model<\/jats:italic> with low\u2010dose oxytocin consisting of 3 groups with the administration of propranolol before and during simulated labor, and a control group. (ii) <jats:italic>Postpartum haemorrhage (PPH) model<\/jats:italic> with high\u2010dose oxytocin consisting of 4 groups with the administration of propranolol during and\/or after augmented labor (desensitised with oxytocin), and a control group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Myometrial contractility was recorded using force transducers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the labor induction\u2010augmentation model, propranolol pre\u2010treatment produced a higher area under the curve (AUC) of myometrial contractility induced by low\u2010dose oxytocin (relative percentage difference [diff]: 20.4%; 95% CI [1.4%, 43.2%], <jats:italic>p<\/jats:italic>\u2009=\u20090.035) compared to control; however, no difference was observed when propranolol was given after the initiation of labor. In the oxytocin\u2010desensitised PPH model, the AUC of myometrial contractility induced by high\u2010dose oxytocin was improved with propranolol pre\u2010treatment (diff 25.4% [0.2%, 56.8%], <jats:italic>p<\/jats:italic>\u2009=\u20090.048), co\u2010treatment (diff 26.7% [3.7%, 54.7%], <jats:italic>p<\/jats:italic>\u2009=\u20090.02), and both pre\u2010 and co\u2010treatment (diff 28.4% [7.0%, 54.1%], <jats:italic>p<\/jats:italic>\u2009=\u20090.007) when compared to the control group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our ex\u00a0vivo study suggests that propranolol can augment uterine activity by approximately 20%\u201325% when administered early during labor induction and augmentation. Clinical studies are warranted to determine the relevance of these findings in\u00a0vivo.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> Identifier: NCT03434444; <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/\">https:\/\/clinicaltrials.gov\/<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.18146","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T22:11:13Z","timestamp":1743027073000},"page":"1228-1237","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Propranolol and Oxytocin\u2010Induced Contractility in Gravid Human Myometrium: An Ex\u00a0Vivo Laboratory Study"],"prefix":"10.1111","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6568-021X","authenticated-orcid":false,"given":"Mrinalini","family":"Balki","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Pain Medicine, Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"},{"name":"Department of Obstetrics and Gynaecology, Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"},{"name":"Department of Physiology University of Toronto  Toronto Ontario Canada"},{"name":"Lunenfeld\u2010Tanenbaum Research Institute Sinai Health System  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren M.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Medicine, Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayalakshmi","family":"Caliaperumal","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Medicine, Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella","family":"Wang","sequence":"additional","affiliation":[{"name":"Biostatistics Department University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ella","family":"Huszti","sequence":"additional","affiliation":[{"name":"Biostatistics Department University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Kingdom","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"},{"name":"Lunenfeld\u2010Tanenbaum Research Institute Sinai Health System  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2020-0305"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181e10c5c"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2018.08.586"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)35051-4"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/4.5.625"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jne.12154"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.22"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1677\/joe.0.1540007"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e318297d347"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-014-0190-1"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-020-01615-6"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1968.tb02031.x"},{"key":"e_1_2_12_14_1","first-page":"812","article-title":"Epinephrine\u2010Like Substances in the Blood and Their Relation to Uterine Inertia","volume":"69","author":"Garcia R. C.","year":"1955","journal-title":"American Journal of Obstetrics and Gynecology"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0233"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016348709020754"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016348909028672"},{"key":"e_1_2_12_18_1","first-page":"491","article-title":"The Effect of Oral Propranolol Plus Oxytocin Versus Oxytocin Only on the Process and Outcome of Labor: A Double\u2010Blind Randomized Trial","volume":"19","author":"Direkvand\u2010Moghadam A.","year":"2014","journal-title":"Iranian Journal of Nursing and Midwifery Research"},{"key":"e_1_2_12_19_1","article-title":"A Randomised Clinical Trial to Determine the Effect of Beta\u2010Adrenergic Blocking With Propranolol on Labour","volume":"19","author":"Cilliers J. B. F.","year":"2013","journal-title":"South African Journal of Obstetrics and Gynaecology"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199810000-00022"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0773.1979.tb02307.x"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(96)00223-2"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2020.100301"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-015-3991-8"},{"key":"e_1_2_12_25_1","first-page":"2567","article-title":"Comparison Effect of Oral Propranolol and Oxytocin Versus Oxytocin Only on Induction of Labour in Nulliparous Women (a Double Blind Randomized Trial)","volume":"7","author":"Moghadam A. D.","year":"2013","journal-title":"Journal of Clinical and Diagnostic Research"},{"key":"e_1_2_12_26_1","first-page":"5","article-title":"Reduction in the Cesarean Section Rate in Nulliparous Patients After Administration of Intravenous Propranolol","volume":"18","author":"Adamsons K.","year":"1999","journal-title":"Puerto Rico Health Sciences Journal"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2005.06.016"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2008.00790.x"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001765"},{"key":"e_1_2_12_30_1","first-page":"124","article-title":"The Effect of Propranolol (Obsidan) as Well as Propranolol and Fenoterol (Partusisten) on the Motility of the Smooth Uterus Musculature In\u00a0Vitro","volume":"45","author":"Peiker G.","year":"1990","journal-title":"Pharmazie"},{"key":"e_1_2_12_31_1","unstructured":"S. A. P.Willet K.Sparrow andS.Cheyene \u201cSurveillance Report 2017\u2013Induction of Labour (2008) NICE Guideline CG70 Surveillance Report 2017\u2013Induction of Labour (2008) NICE Guideline CG70. London National Institute for Health and Care Excellence (NICE) Copyright NICE 2017 \u201d 2017."},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(15)30842-2"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0849-5831(16)31001-1"},{"key":"e_1_2_12_34_1","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1097\/AOG.0b013e3181b48ef5","article-title":"ACOG Practice Bulletin No. 107: Induction of Labor","volume":"114","author":"Committee ACoOaG","year":"2009","journal-title":"Obstetrics and Gynecology"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70611-7"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(84)90355-7"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-21-8-985"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00931436"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2002.811107.x"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2011.03.004"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cellsig.2011.09.019"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cellsig.2011.09.020"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M506576200"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1124\/mol.106.026716"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.18146","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T12:41:10Z","timestamp":1752756070000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.18146"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,24]]},"references-count":43,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1111\/1471-0528.18146"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.18146","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,24]]},"assertion":[{"value":"2024-11-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}