carboprost and Diarrhea

Topics: Animals; Carboprost; Diarrhea; Female; Loperamide; Male; Mice; Muscle Contraction; Piperidines; Rats; Uterine Contraction

To evaluate whether a double prostaglandin impact enhances the effectiveness of the 15S-15-methyl prostaglandin (PG) F2 alpha methyl ester analogue in 1st and 2nd trimester abortion, 2 vaginal suppositories spaced 3 hours apart were administered to 10 patients. The patients' ranged from 19-39 years; length of gestation ranged from 44-56 weeks. Uterine contraceptions began from 40-190 minutes after suppository insertion, and bleeding was seen within 120-610 minutes. 3 of the 10 subjects expelled products of conception during the 10-hour observation period. All subjects reported persistent vaginal bleeding after the procedure, and in 8 subjects the bleeding continued for 14 or more days. 6 subjects reported repeated nausea and vomiting, and 7 experienced diarrhea. Both plasma progesterone values and human chorionic gonadotropin (hCG) beta-subunit levels declined during the 10-hour observation period. The significant drop in beta-subunit hCG levels noted at the follow-up visit indicated 8 of the pregnancies had been successfully interruped showed a drop in plasma progesterone levels, showing that this measure does not predict outcome. Overall, the results in this small series do not suggest any improvement in efficacy over that reported with a single vaginal suppository. The frequency and severity of gastrointestinal side effects appeared to be greater and vaginal bleeding was more porlonged. In addition, uterine contractions began earlier and were more intense, requiring greater use of analgesic medication. It is possible, however, that more applications of smaller dosages given at shorter intervals could improve efficacy and reduce the frequency and severity of side effects.

Topics: Abortion, Induced; Adult; Carboprost; Chorionic Gonadotropin; Diarrhea; Female; Humans; Nausea; Pregnancy; Prostaglandins F, Synthetic; Suppositories; Uterine Hemorrhage

A new approach to terminate very early pregnancy was tried on 49 healthy women who were proven to be pregnant from 31 to 47 days from their last menstrual period. All pregnancies were confirmed either by UCG or serum HCG-B subunit. (15S)-15-Methyl PGF2 alpha Methyl Ester in a suppository form was administered in two separate doses: 1.0 mg initial dose followed by 3.0 mg one hour later. Patients were kept under observation for 8 hours. Blood sampling for progesterone, HCG-B, and prostaglandin levels were assayed at 0 degree, 30', 1 degree, 4 degrees, 8 degrees and 14 days. Patients were re-examined at a two week follow-up visit. Pelvic examination and pregnancy tests were performed to confirm whether the pregnancy was successfully terminated. There were no significant changes in serums progesterone and HCG-B levels during the 8-hour observation period. Both levels declined significantly to very low levels at 14 days post-therapy, confirming the clinical impression of successful termination of pregnancy. Plasma prostaglandin levels rose as early as 30 minutes after initiation of therapy, peaked at 4 hours and declined gradually afterwards. Most side effects such as nausea, vomiting, diarrhea and cramps, although clinically manageable, were still bothersome. One patient experienced an episode of vasovagal syncope. The majority of patients required medical observation up to 6 hours. Clinical implications of this new approach of termination of very early pregnancy are discussed.

Topics: Abortion, Induced; Adolescent; Adult; Carboprost; Chorionic Gonadotropin; Chorionic Gonadotropin, beta Subunit, Human; Diarrhea; Female; Humans; Peptide Fragments; Pregnancy; Progesterone; Prostaglandins F, Synthetic; Suppositories; Uterine Contraction; Vagina; Vomiting