carboprost and Fetal-Death

Thirty pregnant women with foetal death in utero received 15-methyl PGF2 alpha to terminate their pregnancies. Two groups (15 cases each) matched for age, gravidity and age of pregnancy were studied. One group received indomethacin suppositories before and during the PG induction while the second group received the prostaglandin analogue therapy only. The group which received the prostaglandin biosynthesis inhibitor showed a longer induction-termination interval, more PG ampoules were used and the number of failed cases was higher. Thus, the Release of Endogenous prostaglandins seems to play a complementary role in the therapeutic termination of pregnancy.

Topics: Adult; Carboprost; Female; Fetal Death; Humans; Labor, Induced; Pregnancy; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Prostaglandins; Prostaglandins F, Synthetic

The efficacy of 15-(S)-15-methyl-PGF2 alpha in inducing labour in 30 patients with intra-uterine fetal death was tested. The patients were divided into two groups of 15 patients and the drug was administered either by repeated intramuscular injection or by continuous intra-uterine extra-amniotic infusion. The extra-amniotic method of administration was the safest and most successful method (100% v. 93,3%); the duration of labour was shorter (mean 12 hours 39 minutes v. 17 hours 39 minutes); less prostaglandin was required (mean 867 micrograms v. 2300 micrograms); and it was associated with the lowest incidence of side-effects compared with the intramuscular route of administration (no vomiting; 6,6% incidence of diarrhoea v. 60% vomiting and 73,3% diarrhoea). The intramuscular method was further complicated by 1 case of uterine rupture.

Topics: Adolescent; Adult; Carboprost; Female; Fetal Death; Humans; Injections, Intramuscular; Labor, Induced; Oxytocics; Pregnancy; Pregnancy Trimester, Third; Prostaglandins F, Synthetic; Time Factors

Topics: Adult; Blood Transfusion; Carboprost; Ergonovine; Female; Fetal Death; Gestational Age; Humans; Oxytocics; Postoperative Complications; Pregnancy; Suture Techniques; Uterine Hemorrhage; Vacuum Curettage

Topics: Abortifacient Agents; Abortion, Therapeutic; Adult; Blood Transfusion; Carboprost; Diagnosis, Differential; Drug Combinations; Female; Fetal Death; Humans; Hysterectomy; Laparoscopy; Pregnancy; Pregnancy Trimester, Second; Tromethamine; Urinary Bladder Diseases; Uterine Rupture

This study examines whether labor can be induced with the intramuscular administration of 15-(S)-methyl prostaglandin F2 alpha in cases of intrauterine fetal death. The success rate of labor induction in the studied group was 93.75%, and was the same for primigravid and multigravid patients. The authors conclude that the prophylactic administration of an analgesic potentiator, an anti-emetic and an anti-diarrheal is advantageous to a woman's tolerance of the prostaglandin. PGF2 alpha is a quick and effective drug for use in the induction of labor to terminate pregnancies with intrauterine fetal death and offers tolerable side-effects when used with adjuvant medication.

Topics: Adult; Carboprost; Female; Fetal Death; Humans; Injections, Intramuscular; Labor, Induced; Pregnancy; Prostaglandins F, Synthetic; Uterine Contraction

102 pregnant women with intra-uterine fetal death after the 12th week of gestation were treated with 15(S)-15-methyl-prostaglandin F2 alpha intramuscularly with doses of 125-250 micrograms at 2-3 hourly intervals. In all cases abortion or delivery was completed within 30 hours. The average time in primigravidae was 9 hours 43 minutes, and in multigravidae 9 hours and 59 minutes. In approximately two-thirds of the patients, mild or moderate gastrointestinal side effects were recorded in spite of prophylactic treatment with Retardin or Loperamide + Diphenoxylate. The therapy was found to be effective, easy to administer and the side effects acceptable. No serious side effects were recorded.

Topics: Abortion, Induced; Adult; Carboprost; Diphenoxylate; Female; Fetal Death; Gastrointestinal Diseases; Humans; Injections, Intramuscular; Labor, Induced; Loperamide; Postoperative Complications; Pregnancy; Prostaglandins F, Synthetic

Topics: Abortion, Induced; Abortion, Missed; Adolescent; Adult; Carboprost; Female; Fetal Death; Humans; Hydatidiform Mole; Pregnancy; Prostaglandins F, Synthetic; Uterine Neoplasms

Topics: Abortion, Missed; Adolescent; Adult; Carboprost; Female; Fetal Death; Humans; Pregnancy; Prostaglandins F, Synthetic

2a 2b dihomo 15(S) 15 methyl PGF2 alpha methyl ester (dihomo 15 me PGF2 alpha) in intramuscular doses of 0.5 mg 8 hourly was used in 631 patients with abnormal intrauterine pregnancy comprising 282 cases of intrauterine fetal death, 233 cases of missed abortion, 34 and 82 cases respectively anencephalic and molar pregnancies. The study was carried out as a collaborative project between the University Departments of Obstetrics and Gynaecology in Singapore (Singapore), Medan (Indonesia) and Kuala Lumpur (Malaysia) during the period June 1974 and November 1979. Six hundred patients (95.1%) aborted or delivered in a mean time of 11.3 hours (S.D. +/- 7.0) with an average of 1.8 injections of the prostaglandin analogue per patient. Side effects included vomiting (23.6%; mean 0.45 episodes per patient), diarrhoea (44.4%; mean 1.00 episode per patient), cold and shivering (11.9%) and pyrexia (12.4%). One patient sustained a cervical laceration which did not require repair. There were no complications.

Topics: Abortion, Missed; Anencephaly; Carboprost; Ethnicity; Evaluation Studies as Topic; Female; Fetal Death; Humans; Hydatidiform Mole; Pregnancy; Prostaglandins F, Synthetic; Uterine Neoplasms

Intramuscular injection of 15-methyl-PGF2 alpha was used to induce 48 terminations of pregnancy in the second trimester as well as to deliver 8 cases of death in utero and one hydatidiform mole. It is an effective method of treatment with a failure rate of 1.9%. As compared to the administration of pain-relieving drugs intravenously, continuous epidural analgesia has shown itself to be the only method which will allow the best possible conditions for the maintenance and control of prostaglandin induction to be carried out, suppressing effectively even the pains which are associated with uterine contractions brought on by prostaglandin. Although this method of systemic administration of prostaglandin does avoid any intervention through the cervicovaginal route, it does not completely do away with rare infections which are found to complicate matters when PGF2 alpha gel is administered by the extra-amniotic route. All the same, the acceptability and use of this method as a routine method must be limited by the high incidence of episodes of diarrhoea which are made worse by paralysis of the sphincters that is inseparable from epidural analgesia.. Intramuscular injections of 15-methyl-prostaglandin F2alpha (PGF2alpha) were used to induce 48 terminations of pregnancy in the 2nd trimester as well as to deliver 8 cases of fetal death in utero and 1 hydatidiform mole. It is an effective method of treatment with a failure rate of 1.9%. As compared to the administration of pain-relieving drugs intravenously, continuous epidural analgesia has shown itself to be the only method which will allow the best possible conditions for the maintenance and control of PG induction to be carried out, suppressing effectively even the pains which are associated with uterine contractions brought on by PGs. Although the method of systemic administration of PGs does avoid any intervention through the cervicovaginal route, it does not completely do away with rare infections which are found to complicate matters when PGF2alpha gel is administered by the extraamniotic route. Nevertheless, the acceptability and use of this method as a routine method must be limited by the high incidence of episodes of diarrhea which are made worse by the paralysis of sphincters which is inseparable from epidural analgesia. (author's)

Topics: Abortifacient Agents; Abortifacient Agents, Nonsteroidal; Adolescent; Adult; Anesthesia, Epidural; Carboprost; Delivery, Obstetric; Female; Fetal Death; Humans; Injections, Intramuscular; Pregnancy; Pregnancy Trimester, Second; Prostaglandins F, Synthetic; Uterine Contraction

Changes in the coagulation mechanism were studied during and after 15(S)-15-methylprostaglandin F2 alpha (15-me-PGF2 alpha) administration for termination of pregnancy because of intrauterine fetal death after 20 wk pregnancy. 12 patients, of whom 2 were under and 6 over 28 wk, were studied. 2-Hourly intramuscular administration of 250 microgram 15-me-PGF2 alpha resulted in expulsion in a median time of 9 h (range: 2-24.3 h). Although the drug may have some inhibitory effect on platelet aggregation, its influence on coagulation and the hemostatic mechanism was negligible.

Topics: Abortion, Induced; Blood Coagulation; Carboprost; Female; Fetal Death; Hemostasis; Humans; Platelet Aggregation; Pregnancy; Prostaglandins F, Synthetic

The efficacy of (15S)-15-methyl-prostaglandin F2 alpha in terminating pregnancy in cases of known missed abortion, hydatidiform mole and intra-uterine fetal death was tested. There were 8 cases of missed abortion, 13 cases of intra-uterine death at or after 28 weeks' gestation, and 1 case of hydatidiform mole. No other oxytoxic preparation was required in 19 (86%) patients. The mean induction-to-delivery time was 17,2 hours in the group with missed abortions and 12,4 hours in the group with intra-uterine deaths, and the maximum blood loss was 350 ml. Gastro-intestinal side-effects, which were present in 21 (95%) patients, were severe in 5 (23%).

Topics: Abortion, Eugenic; Abortion, Induced; Abortion, Missed; Adult; Carboprost; Female; Fetal Death; Humans; Hydatidiform Mole; Injections, Intramuscular; Pregnancy; Pregnancy Complications; Prostaglandins F, Synthetic; Time Factors