PubMed · 12265636
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M Potts. 1983. Looking into the future.. https://pubmed.ncbi.nlm.nih.gov/12265636/
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Women undergoing medical abortions require different types of pain relief, severe pain being a problem. This study compared the pain relief required during a medical abortion at the Departments of Gynecology in Kalmar and Karlskrona. The case notes of 100 women at each department were examined. Considerable differences between the two departments were found. In Kalmar women were mainly given paracetamol and dextropropoxyphene at the start of the procedure, while in Karlskrona women were usually given suppository diclofenac. In Kalmar 42 per cent of the women needed some form of opiate during the abortion, while in Karlskrona only 8 per cent required opiates.
Isocupressic acid (1) was used to synthetically prepare a mixture of (8S,13R,S)-labda-15,19-dioic acid (tetrahydroagathic acid) (5) via a two-step oxidation procedure followed by hydrogenation of the double bonds at C13 and C8. Reduction of the C8,17 double bond was stereospecific producing only the 8S isomer and confirmed by the nOe interaction between the resulting C17 and C20 methyl groups. The 13R and 13S isomers of 5 were separated and analyzed by HPLC/MS, and (13S)-tetrahydroagathic acid was isolated and identified by comparison to a standard prepared by hydrogenation of naturally occurring (13S)-dihydroagathic acid (4). (13R,S)-dihydroagathic acid was prepared by selective sodium metal-catalyzed hydrogenation of the C13,14 allylic double bond of agathic acid (3). The prepared compounds were then used as standards to confirm the presence of 4 and 5 and their respective 13R and 13S isomers in bovine serum samples. Tetrahydroagathic acid was shown to be the only metabolite detected in serum samples taken from a suspected cattle abortion case submitted for diagnosis; and, thus, 5 could be a valuable diagnostic marker for pine needle-induced abortions.
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