The efficiency and safety of Lamicel, a new synthetic cervical ripening agent, were compared with those of intravaginal prostaglandin E2 gel in a group of 80 primigravid women about to undergo induction of labor. Lamicel caused less uterine activity and fetal distress than prostaglandin gel, although the induction-delivery intervals were similar in both groups. More normal deliveries occurred in the Lamicel group than in the prostaglandin group. It is suggested that Lamicel is a useful, efficient preinduction ripening agent that is safer than intravaginal prostaglandin gel.

Apgar Score↗

PubMed1984

Premenstrual syndrome: weight, abdominal swelling, and perceived body image.

One hundred forty-eight menstrual cycles were studied in 52 women, and in each cycle various parameters were measured to determine an objective means of assessing the syndrome. Daily mood assessment, body weight, plasma 17 beta-estradiol levels, and plasma progesterone levels were measured. The abdominal dimensions were measured in the lateral and anteroposterior diameters at the level of the umbilicus and 10 cm below; at the same time the same dimensions were measured as perceived by the patient. Mood score showed a marked increase during the premenstrual phase of each cycle. The symptom of bloatedness was marked during the premenstrual phase of the cycle. Despite these highly elevated scores for bloatedness there was no increase in body weight or the measured body dimensions in any plane. However, the patient's perception of body size did increase, and the discrepancy between the perceived body size and the actual body size (perception error) was significant.

Body Image↗

PubMed1984

Preoperative dilatation of the first-trimester cervix: a comparison between Lamicel and 16,16-dimethyl-trans delta 2 prostaglandin E1 methyl ester pessaries.

Both Lamicel and 16,16-dimethyl-trans delta 2 prostaglandin (PG) E1 methyl ester pessaries have recently been shown to be effective for cervical dilatation prior to first-trimester abortion. In the study described, the force required to dilate the cervix prior to vaginal termination of pregnancy was measured in three groups of patients--a control group, a group which received Lamicel , and a group which received 16,16-dimethyl-trans delta 2 PGE1 methyl ester pessaries. The total force required to dilate the cervix to 10 mm was significantly reduced in the treated groups, but there was no significant difference between the two treatment regimens. The use of Lamicel is associated with fewer side effects.

16,16-Dimethylprostaglandin E2↗

PubMed1984

A force sensor and peak-reading recorder for measurement of cervical dilatation force.

Earlier dilatation force-sensing transducers, when subjected to side loads, suffered frictional losses which affected their accuracy. This new instrument incorporates a thermal-writing chart recorder and a digital readout of the peak force during dilatation of the cervix.

Biomedical Engineering↗

PubMed1983

Cervical dilatation by Lamicel--studies on the mechanism of action.

Lamicel is a synthetic hydrophilic polymer tent which produces cervical softening and dilatation when inserted into the endocervical canal. To investigate the mechanism of action of Lamicel, the intrauterine pressure and levels of 6-keto-prostaglandin F1 alpha, 13-14-dihydro-15-keto-prostaglandin F2 alpha, oestradiol and progesterone in plasma and amniotic fluid were measured in patients undergoing second trimester abortion. There was no significant change in any of the measured hormones during a 2-h treatment with Lamicel, but uterine activity increased significantly for 10 min after insertion, then settled spontaneously to below pre-treatment levels. Peripheral plasma levels of magnesium sulphate measured in patients undergoing first trimester abortion were not significantly raised after insertion of Lamicel. Light microscopic examination of cervical specimens, obtained at hysterectomy from patients pre-treated with Lamicel for 24 h, revealed minimum increase in vascularity, mast cell population and ground substance mucopolysaccharides.

6-Ketoprostaglandin F1 alpha↗

PubMed1983

Lamicel: a new technique for cervical dilatation before first trimester abortion.

Mechanical dilation of the cervix can be both difficult and dangerous and has potentially serious complications. Lamicel, a synthetic hydrophilic polymer, was inserted into the cervix between 2 and 24 h before termination by vacuum aspiration in the first trimester in 48 nulliparae. A control group of 12 nulliparae were not treated with Lamicel. The force needed to dilate the cervix, accurately measured with a specifically designed force-measuring instrument, was found to be significantly reduced in all treated groups. The greatest rate of dilatation occurred within the first 2 h after insertion.

Abortion, Induced↗

PubMed1983

Changes in plasma steroid hormones during treatment of preterm labour with ritodrine-HCl.

Peripheral plasma concentrations of unconjugated oestradiol 17-beta, progesterone and total oestriol were measured in 21 patients presenting with 'uncomplicated' preterm labour. Serial measurements were made during intravenous treatment with ritodrine over a period of 24 h. Mean levels of unconjugated oestradiol 17-beta fell significantly during infusion with ritodrine. Changes in progesterone levels remained within the range of diurnal fluctuations normally found in uncomplicated late pregnancy. Mean total oestriol levels fell significantly, but the changes did not exceed normal variations. No correlation was found between the magnitude, the rate or the timing of changes in any of the hormones measured and the short or long term effects of ritodrine on uterine activity. Although alterations in the peripheral oestrogen concentrations may be a direct effect of beta-mimetics, it is unlikely that this mechanism is important in the inhibition of uterine activity.

Adolescent↗

PubMed1981

The titanium/silicone rubber clip for female sterilization.

A composite titanium/silicone rubber clip has been developed for female sterilization. The 12.7 mm long metal clip is lined with silicone rubber and is bent round the Fallopian tube by means of an applicator that can be used laparoscopically. As tubal necorsis occurs, the rubber expands to keep the lumen blocked. The tube eventually divides and the stumps heal closed. Since the Mark 3 version of the clip was introduced, over 5700 women in several countries have been sterilized. The first 540 British women who were followed-up for five to 17 months experienced one method failure (ectopic) and tow operator failures, to total failure rate of 5.5/1000. Clip-related complications were minimal and long-term sequelae were comparable to tubal ligation. The clip causes minimal destruction but still seems effective for tubal occlusion and it can accommodate thick tubes.

Adolescent↗

PubMed1980

Flurbiprofen in the management of dysmenorrhoea.

The analgesic effect of flurbiprofen, aspirin and placebo in the treatment of primary dysmenorrhoea was compared in 41 patients using a double blind triple crossover study. No statistically significant differences were found between any pair of treatments and the control for pain relief. Thirty patients had assessments for all three treatment months, 11 preferred flurbiprofen, 9 preferred placebo, 6 preferred aspirin and 4 had no preference between any of the treatments. Side effects were reported by 14 of the 41 patients: 3 during the control month, 6 during the flurbiprofen month, 4 during the aspirin month and 7 during the placebo month.

Adolescent↗

PubMed1978

The distribution of arachidonic acid in plasma and tissues of patients near term undergoing elective or emergency Caesarean section.

The distribution of arachidonic acid in both the free and the bound state was measured in the maternal circulation, the fetal circulation and tissues within the pregnant uterus in 16 patients undergoing Caesarean section. Half of the patients had an elective Caesarean section and half had a Caesarean section during labour. No differences in arachidonic acid concentrations were found between the maternal or fetal circulations in women having elective Caesarean section and those having a Caesarean section in labour. The total and bound values of arachidonic acid in myometrium were higher in patients undergoing Caesarean section in labour. There was also an increased amount of arachidonic acid when expressed as an arachidonic acid/palmitic acid ratio between the fetal circulation and the maternal circulation, suggesting an active transport mechanism for arachidonic acid across the placenta. Levels of free arachidonic acid were in microgram quantities in both plasma and tissues, suggesting that the availability of free arachidonic acid was not the limiting factor in prostaglandin production.

Adolescent↗

PubMed1978

The passage of fat emulsion across the human placenta.

Six patients near term were given an intravenous infusion of a fat emulsion (Intralipid) a few hours before normal delivery or Caesarean section. Six other non-infused patients were studied as controls. Maternal venous and umbilical venous and arterial blood samples were taken at delivery and analyzed for individual fatty acid concentrations in triglyceride, free fatty acid (FFA) and phospholipid fractions. The emulsion, being rich in oleic and linoleic acids, affected the composition of the maternal triglycerides. The fetal lipids were also altered and the infusions resulted in large positive umbilical venous-arterial (v-a) differences in FFA and triglyceride fatty acid concentrations, but this was not the case for phospholipid concentrations. The fatty acids with the largest v-a differences were those prominent in the emulsion.

Adult↗

PubMed1977

The effect of prostaglandin E2 on the cardiovascular response to angiotensin II in pregnant rabbits.

The rise in arterial blood pressure in response to angiotensin II was studied in the last third of pregnancy in rabbits. The response was compared with that of pregnant rabbits during infusion of prostaglandin E2 and F2alpha. Prostaglandin E2 significantly diminished the rise in diastolic pressure in response to angiotensin II. Prostaglandin F2alpha did not alter the response. Intravenous indomethacin elevated the blood pressure and caused an absolute increase in the pressor response. It did not mediate a change in the percentage rise in blood pressure in response to angiotensin II.

Angiotensin II↗

PubMed1977

Hodgkin's disease diagnosed in pregnancy, case report.

A patient is described in whom Hodgkin's disease was diagnosed and treated during the antenatal period, and who was delivered of a premature, but otherwise normal, infant.

Adult↗