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At least 19 recordsLinked to original sources
PubMed1989

Circulating levels of placental protein 12 and chorionic gonadotrophin following RU 38486 and gemeprost for termination of first trimester pregnancy.

First trimester termination of pregnancy was successfully induced in ten patients with RU 38486 followed 2 days later by a prostaglandin (Gemeprost) pessary. Human chorionic gonadotrophin (HCG) values remained unaltered until after the abortion. The levels of placental protein 12 (PP12) showed an immediate and significant fall following RU 38486, then rose to values substantially higher than those at the initial visit after 2 days. These findings show that RU 38486 has a direct inhibitory effect on tissues producing PP12 and confirm the progesterone dependency of this protein.

Abortifacient Agents↗
PubMed1989

The problematic first-trimester pregnancy.

The first-trimester obstetric patient who is experiencing pain or bleeding may have a normal intrauterine pregnancy, a threatened miscarriage, an ectopic pregnancy, a blighted ovum or trophoblastic disease. Correlation of clinical findings, quantitative human chorionic gonadotropin levels and diagnostic ultrasound findings can maximize the efficiency of the work-up, provide a definitive prognosis and identify early ectopic pregnancy.

Abortion, Spontaneous↗
PubMed1992

Flow-cytometric analysis of immune cell populations in human decidua from various types of first-trimester pregnancy.

We undertook an investigation in which flow cytometry was used to characterize immune cell populations in the decidua of first-trimester normal pregnancies, spontaneous abortions, and ectopic pregnancies in comparison to the nonpregnant endometrium to demonstrate how the proportions of immunocompetent cell populations at the fetomaternal interface are influenced by the presence and state of a fetoplacental allograft. No significant differences were found in the decidua of the different types of first-trimester pregnancy in the proportions of the CD45+, CD14+, CD3+, CD4+, CD8+, CD19+, CD3-/CD16+ and/or CD56+, CD3+/CD16+ and/or CD56+, CD4+/Leu-8+, CD4+/Leu-8-, CD8+/CD11b+, CD8+/CD11b-, and CD3+/HLA-DR- decidual leukocyte subsets. However, the percentage of decidual CD3+/HLA-DR+ cells, which are characteristic of activated T cells, was significantly higher in spontaneous abortions than in normal pregnancies (p less than 0.05). This suggests that the accumulation of decidual leukocytes may be regulated mainly by hormones and/or cytokines rather than by the presence and state of an intrauterine conceptus and that on/off-switching of activation of decidual T cells may be associated with successful maintenance of the implanted embryo.

Abortion, Spontaneous↗
PubMed1991

[Echography in the first pregnancy trimester has prognostic value].

Clinical and ultrasound data of 403 first-trimester pregnancies were collected prospectively. Consequences for determination of gestational age as well as the risk of spontaneous abortion were investigated. There was a clear relation between embryonal growth delay and the risk of spontaneous abortion: the risk of spontaneous abortion was significantly higher if the crown-rump length lagged 7 or more days behind the expected gestation time based on the duration of the amenorrhoea (16% versus 5.0%; p less than 0.01). It is important to know the exact duration of pregnancy, because a difference of one or two weeks can be critical in terms of survival or disability. 22.7% of the pregnant women who had a regular menstrual cycle before this pregnancy appeared to have an embryonal growth delay of seven days or more in relation to the reference curve. This illustrates the necessity of crown-rump length measurements in order to obtain accurate assessment of gestational age, which is fundamental in obstetric care.

Abortion, Spontaneous↗
PubMed1989

Circulating levels of placental protein 14 and progesterone following Mifepristone (RU38486) and Gemeprost for termination of first trimester pregnancy.

Ten patients underwent successful termination of first trimester pregnancies with RU38486 (Mifepristone, Roussel Laboratories Ltd., Broadwater Park, Uxbridge, Middlesex, United Kingdom) followed 2 days later by a prostaglandin (Gemeprost, May and Baker Ltd., Dagenham, Essex, United Kingdom) pessary. Four hours after administration of RU38486, the levels of progesterone (P) started to fall and continued to show a gradual decline until the abortion was completed, when a steep fall to follicular phase values was observed. Levels of placental protein 14 remained unaltered until 2 days after RU38486 administration, when levels were increased. The rise in placental protein 14 in association with falling P concentrations suggests that the decidual secretion of placental protein 14 might be independent of P. Fertil Steril 52:66, 1989.

Abortifacient Agents↗
PubMedDate not supplied

Failed first trimester pregnancy termination: uterine anomaly as etiologic factor.

Failure of first trimester pregnancy termination is an uncommon, although potentially serious complication of attempted therapeutic abortion. We report our experience in four patients with unsuspected congenital uterine anomalies in whom attempted pregnancy termination procedures failed to completely ablate the products of conception. When dilatation and curettage fails to produce embryonic tissue, sonography is indicated to exclude ectopic gestation or uterine anomaly. In patients who are known to have anomalous uteri, intraoperative real-time guidance may increase the success of pregnancy termination procedures and decrease the incidence of retained products of conception.

Abortion, Therapeutic↗
PubMed1990

A randomized double blind study of a new ready-for use prostaglandin gel (Org 2436) for cervical ripening prior to first trimester pregnancy termination.

In a placebo-controlled double-blind randomized study involving 50 primigravidae scheduled for termination of first trimester pregnancy 500 micrograms PGE2 gel or placebo gel were applied intracervically 6 hours before curettage. The priming effect was verified in all patients by means of comparative examinations with a special tonometer before application of the gel and immediately before the surgical procedure. No abortion or vaginal bleeding occurred in any of the patients. After 500 micrograms PGE2 gel the mean free passability (i.e. force less than or equal to 1 Newton) was 7.8 (+/- 2.0) mm, the corresponding value for the placebo group 5.2 (+/- 1.2) mm (p less than 0.0001). The prostaglandin pretreatment led to a significant increase in dilation of 5.9 +/- 2.3 mm versus 2.0 +/- 1.2 mm in the placebo group (p less than 0.0001). 17 of the 25 PGE2-treated patients complained of lower abdominal pain, gastrointestinal side effects were observed in one of these patients. In the placebo group there were no undesired concomitant symptoms. No intra- or postoperative complications occurred in the PGE2 gel-treated group. After application of the placebo gel cervical lesions and incomplete curettages were demonstrated in 4 cases. According to this preliminary experience, the intracervical application of the new ready-for-use-PGE2 gel represents a practicable and efficient method for preoperative cervical priming. In view of the intraoperative complications in the placebo group the frequency of side effects after PG application are within tolerable limits.

Abortion, Induced↗
PubMed1985

Repeated first-trimester pregnancy loss: evaluation and management.

The clinical management of repetitive first-trimester pregnancy loss is handicapped by inadequate answers to four fundamental questions. These questions center around understanding the true scope of the problem, differentiating between euploidic and aneuploidic loss, identifying the parental source of the gametogenic error, and clarifying the role of molecular developmental mutants in euploidic abortion. In spite of these limitations a diagnostic and therapeutic program is outlined for couples with repetitive early abortion. Informational gaps are identified and the future role of molecular biology in clarifying some of these issues is optimistically outlined.

Abortion, Habitual↗
PubMed1987

Complicated first-trimester pregnancies: evaluation with endovaginal US versus transabdominal technique.

Endovaginal ultrasound (US) was performed in 38 pregnant women at 5-12 menstrual weeks, when the initial transabdominal sonograms had been considered inconclusive or equivocal. Clinical follow-up disclosed 32 intrauterine pregnancies (12 living, 18 spontaneous incomplete abortions, and two embryonic demises) and six ectopic pregnancies. In the 32 intrauterine pregnancies (normal and abnormal), the correct diagnosis was made in all cases with endovaginal US. The endovaginal images demonstrated the intrauterine embryo, its heart motion, and the yolk sac more clearly and more often when these structures were not apparent on the transabdominal scans. Abnormal gestational sacs were better resolved. In the six cases of ectopic pregnancy, while an extrauterine ectopic sac was visualized in only three, absence of an intrauterine gestational sac was confirmed in all cases with endovaginal scanning. No endovaginal study yielded less information than its transabdominal counterpart. Endovaginal sonography is likely to be diagnostic when transabdominal images fail to yield a definitive diagnosis in early pregnancies.

Abdomen↗
PubMed1991

Reliability of transvaginal ultrasound in detecting first trimester pregnancy abnormalities.

OBJECTIVE: To evaluate the reliability of transvaginal ultrasound (US) and human chorionic gonadotropin (hCG) levels in detecting early abnormalities and predicting outcome of pregnancy. PATIENTS: One hundred thirty-two patients were studied, of which 113 had an intrauterine pregnancy and 19 had an ectopic pregnancy (EP). RESULTS: In 78 with singleton normal pregnancies, US revealed a normal crown-rump length, heart motion, and hCG levels between 1,000 to 107,000 mIU/mL. Of 16 patients with small crown-rump length, heart motion present, and normal hCG levels, 6 aborted and 10 reached term. Thus, 6 of 84 (7.14%) singleton with fetal heart motion aborted. Thirteen with small crown-rump and absent heart motion also aborted. All 8 with an empty gestational sac aborted. In 8, transvaginal US detected four twins, two triplets, and two quadruplets, whereas hCG was not discriminative. Transvaginal US revealed an empty uterus in 19 patients with an EP, whereas serum hCG varied between 37 and 10,500 mIU/mL. CONCLUSION: A fetal crown-rump length compatible with gestational age and fetal heart motion seen by transvaginal US can predict a term pregnancy in greater than 90% of patients.

Abortion, Spontaneous↗
PubMed1985

Use of a modified test system to determine early pregnancy factor (EPF) levels in patients with normal first trimester pregnancy and after therapeutic abortion.

Human pregnancy can be recognized as early as 48 hours after conception using the rosette inhibition test (RIT) to detect early pregnancy factor (EPF). A modification of the test as originally described by Morton et al. is demonstrated using a monoclonal pan T-cell antibody. Studies were performed to investigate the relationship between EPF levels during normal first trimester intact pregnancies and therapeutic abortions. The change in EPF levels is compared with those of hormones after interrupted pregnancy.

Abortion, Therapeutic↗
PubMed1991

Advances in the diagnosis of first-trimester pregnancy problems.

Prompt diagnosis of problems in the first trimester of pregnancy is facilitated by ultrasound scanning and quantitative serum human chorionic gonadotropin and progesterone testing. When used appropriately, these tests can determine whether a patient has a normal early pregnancy, a miscarriage, a missed abortion, an ectopic pregnancy or a hydatidiform mole.

Chorionic Gonadotropin↗
PubMed1990

Changes in circulating alphafetoprotein following administration of mifepristone in first trimester pregnancy.

The occurrence of fetomaternal haemorrhage was investigated in 30 women by measuring maternal serum alphafetoprotein (AFP) levels before and after the administration of mifepristone (RU 486) for termination of first trimester pregnancy. A significant rise in AFP levels was seen in 21 women (70%), the increase ranging from 6 to 660% of baseline levels. The apparent frequency of fetomaternal haemorrhage was similar to that reported previously for surgical termination of first trimester pregnancies.

Abortifacient Agents, Nonsteroidal↗
PubMed1975

Cervical dilatation with prostaglandin analogues prior to vaginal termination of first trimester pregnancy in nulliparous patients.

Dilatation of the cervix with prostaglandin analogues prior to vaginal termination of pregnancy was attempted in 125 nulliparous women in the first trimester of pregnancy. The patients were divided into five groups (25 in each group) and given a single extra-amniotic dose of one of the following prostaglandin analogues 14-16 hours prior to the evacuation of the uterus by vacuum aspiration. (Group A) 15 (S) 15 methyl PGE2 (free acid); (Group B) 15 (S) 15 methyl PGE2 methyl ester; (Group C) 15 (S) 15 methyl PGF2alpha (free acid); (Group D) 15 (S) 15 methyl PGF2alpha methyl ester and(Group E) a mixture of 15 (S) 15 methyl PGE2methyl ester and 15 (S) 15 methyl PGF2alpha methyl ester. Evacuation of the uterus without mechanical dilatation of the cervix was possible in 111 (90%) of the patients. In an additional 10 patients (8%) there was some degree of cervical dilatation and further mechanical dilatation could be performed easily. With the combination of 15 (S) 15 methyl PGE2 methyl ester and 15 (S) 15 methyl PGF2alpha methyl ester the incidence of gastrointestinal side effects and pyrexia were considerably reduced.

Abortion, Induced↗
PubMed1987

Two different methods of prostaglandin administration for cervix priming before interruption of the first trimester pregnancy.

Priming of uterine cervix with PGF2 alpha has been applied to 253 primigravidae before interruption of first trimester pregnancy. Of them, 140 patients were treated with intracervical PGF2 alpha, while 113 other patients with extraamniotic PGF2 alpha. Spontaneous abortion or complete dilatation occurred in 65% of cases in the first group and in 68% in the second one. Side effects were observed less frequently with intracervical application but no serious complication occurred in either of the groups. Intracervical application of PGF2 alpha gel is recommended because of its effectiveness and low rate of side-effects.

Abortion, Induced↗
PubMed1986

Purification of human secretory pregnancy-associated endometrial alpha 2-globulin (alpha 2-PEG) from cytosol of first trimester pregnancy endometrium.

Pregnancy-associated endometrial alpha 2-globulin (alpha 2-PEG), the major secretory protein as assessed by in-vitro synthesis and secretion by the endometrium during the luteal phase of the menstrual cycle and early first trimester of pregnancy, has been purified from the cytosolic fraction of pregnancy endometrium. The purification schedule involved anion exchange chromatography (DE52), gel filtration (Sephacryl S-200), concanavalin A-Sepharose, chromatofocusing and negative immunoaffinity chromatography. On anion exchange chromatography alpha 2-PEG eluted at 0.11 M NaCl, on Sephacryl S-200 with an apparent Mr of 56 K, it bound to concanavalin A and eluted from a chromatofocusing column at a pH of 4.6. alpha 2-PEG was isolated with 98% purity, as assessed by one-dimensional sodium dodecyl sulphate (SDS)-gradient polyacrylamide gel electrophoresis (subunit Mr under reducing conditions 28 K), and a yield of 0.11 mg per g wet weight tissue. This purified alpha 2-PEG should enable in-vitro assessment of the function of this unique protein in implantation and pregnancy and provide antigenic material for the development of a radioimmunoassay.

Chromatography, Affinity↗