PubMed Health⌕ Search

Biomedical subjects

A Leader

Publications and source records attributed to A Leader.

63 records · Page 4Linked to original sources

Induced abortion in the 8-9th week of pregnancy with vaginally administered 15-methyl PGF2alpha methyl ester.

15(S)15-methyl PGF2alpha methyl ester was self-administered vaginally to terminate pregnancy in 42 women in the 8-9th week of gestation. Ten patients received a total of 6 mg of the compound over 15 hours (Group I) while the remaining 32 patients received 5.5 mg of the prostaglandin compound during a shorter period of time or 9 hours (Group II). If parts of the conceptus were expelled during treatment, surgical intervention was excluded. All patients were followed closely after treatment with repeated serum HCG assays and clinical examinations. All patients in Group II and eight out of ten patients in Group I aborted following treatment. In 33 of the 42 patients, the serum HCG levels and the clinical course following the expulsion of the conceptus indicated that abortion was complete. Gastro-intestinal side effects were minimal if anti-diarrheic agents were given prophylactically. The incidence of uterine pain was variable but could in most cases be controlled by oral or rectal administration of analgetics. The results of this study suggest that the use of this compound for termination of pregnancy may be safely extended through the 9th week of gestation and in certain cases be an alternative to the normal operative procedure.

Abortion, Induced↗

Vaginally administered 16, 16-dimethyl-PGE2 for the induction of midtrimester abortion.

Thirty patients in the 13th-20th week of gestation underwent therapeutic abortion utilizing vaginally administered 16, 16-dimethyl-PGE2 (free acid) suppositories. The first 15 patients obtained individual doses in the range of 400-1200 mug given every three hours (mean total dose 4.2 mg). In the following 15 patients a fixed dose schedule was used (800 mug followed by 1000 mug every three hours; mean total dose 5.3 mg). All but one of the 30 patients aborted. The mean induction-abortion interval for all patients was 16.8 +/- 6.9 hours (mean +/- S.D.) With the fixed dose regime the success rate was 100% and the induction-abortion interval 16.0 +/- 5.9 hours. Because gastro-intestinal side effects were minimal, neither anti-emetic nor anti-diarrheic medication was required. A slight elevation of temperature was noted in five patients. The uterine response to the vaginal administration of this compound was characterized by a gradual increase in uterine tonus followed by sustained stimulation. The results are interpreted to suggest that the vaginal administration of 16, 16-dimethyl-PGE2 is a useful alternate method for the induction of second trimester abortion. Moreover, this compound seems to cause fewer gastro-intestinal side effects than other prostaglandins administered by the vaginal route at our department.

Abortion, Induced↗

Early pregnancy interruption by 15 (S) 15 methyl prostaglandin F2alpha methyl ester.

Suppositories of 15-methyl PGF2alpha methyl ester in triglyceride were administered vaginally to 75 women in whom 31 to 49 days had elapsed since their last menstrual period. Three or four suppositories of 0.5, 1.0, or 1.5 mg were given at intervals of 3 hours. Pregnancy was later confirmed in 63 of the women. In the pregnant women vaginal bleeding usually started 3 to 6 hours after the initiation of therapy and continued for 10 to 14 days. Patients were followed for 2 to 4 weeks with serial measurement of serum progesterone and hCG. There were no failures in the trial, but in 2 cases the treatment resulted in incomplete abortion. In 2 other patients curettage was performed due to prolonged bleeding, but histologic examination revealed no remaining signs of pregnancy. Gastrointestinal side effects were well within acceptable limits, and no serious complications occurred. Clinical signs of pelvic inflammatory disease were not found. The vaginal use of 15-methyl PGF2alpha methyl ester seems promising as a reliable outpatient nonsurgical self-administered procedure for termination of early pregnancy.

Abortion, Incomplete↗

The effect of infusions with two analogues of prostaglandin F2alpha on corpus luteum function.

With the exception of one volunteer given the prostaglandin during ovulation, a transient decline in progesterone during the infusion was observed with both compounds. It is likely that the marked declines that were observed cannot be attributed solely to diurnal variation. Although the menstrual cycle was shortened in some cases after the infusion, this was not well-correlated with the acute effects seen at the time of infusion. Under the experimental conditions of this study, neither analogue appeared to be luteolytic. However, infusions with both compounds did alter serum progesterone transiently. It seems likely that both compounds do exert a potent effect on the corpus luteum and may in fact be luteolytic when given at some other time in the menstrual cycle.

Adult↗

Prostaglandins and post-abortion luteolysis in early pregnancy.

This study was undertaken to determine if post-abortion luteolysis in early pregnancy could be accelerated by the administration of 15(S)15-methyl-PGF2alpha(15-me-PGF2alpha) or delayed following pretreatment with indomethacin. Thirty-nine women were divided into four groups: 7 women were given 400mug 15-me-PGF2alpha extra-amniotically one hour prior to vacuum aspiration; 14 were pretreated with oral indomethacin (50 mg X4) over 24 hours; 7 were given indomethacin (50mg X 6) over 36 hours and 11 served as controls. Plasma progesterone and estradiol were measured at fixed intervals before and after abortion. There was a rapid drop in the plasma progesterone within the first hour after abortion followed by an exponential decline over the next 23 hours. The plasma estradiol fell rapidly duriing the same period. Under the experimental conditions of this study neither 15-me-PGF2alpha nor indomethacin exerted a significant effect on the decline in luteal function. These results are interpreted as suggesting that factors other than prostaglandins have a more significant role in post-abortion luteolysis.

Abortion, Induced↗

Vaginally administered 16, 16-dimethyl-prostaglandin E2 as an agent for pre-operative cervical dilatation.

Twenty-one women in the 10th-12th week of pregnancy were treated prior to vacuum aspiration with vaginal suppositories containing 16, 16-dimethyl-PGE2 (free acid). An average total dose of 3.4 mg led to abortion or adequate cervical dilatation in all patients. Based upon previous experience with the compound, no prophylactic anti-emetic or anti-diarrhetic medication was given. Gastrointestinal side effects were minimal. Excessive bleeding was not observed. In two cases, slight temperature elevation was noted prior to abortion. The low incidence of side effects in combination with the effectiveness of the compound help to make this method an attractive therapeutic adjunct to vacuum aspiration beyond the 10th week of gestation. Under the experimental conditions of this study, the results suggest that vaginally administered 16, 16-dimethyl-PGE2 can be a safe and effective method for cervical dilatation before vacuum aspiration.

Abortion, Induced↗