carboprost and Hydatidiform-Mole

Termination of abnormal pregnancy has long been a major gynecological problem. Both surgical and non-surgical procedures are associated with a significant risk for both minor and major complications. Treatment with natural prostaglandins and especially prostaglandin analogues administered by non-invasive routes seems to be an attractive alternative to methods in current use. In the present study 68 consecutive patients with a missed abortion or hydatiform mole were treated with vaginal suppositories containing either 15-methyl-PGF2 alpha methyl ester or 9-deoxo-16,16-dimethyl-9-methylene PGE2. When the uterine size at treatment was 13 weeks or less, vacuum aspiration was performed 12 hours after start of prostaglandin therapy (group I: 41 patients). When the uterus was larger, curettage was performed only after abortion (group II: 27 patients). In group I approximately 45% of the patients aborted within 12 hours from the start of prostaglandin treatment. In the remaining patients the cervical canal was sufficiently dilated and the uterus contracted to allow an easy evacuation. In group II all patients aborted within 26 hours from start of therapy. No serious complications were observed. Both prostaglandin analogues seemed equally effective in terminating an abnormal pregnancy. The E analogue has the advantage of causing significantly fewer gastro-intestinal side effects than the F analogue, though temperature elevation is more common with the former. It may be concluded that vaginal administration of prostaglandin analogues is a simple and effective therapy for termination of abnormal pregnancy and seems to offer considerable advantages over methods in current use.

Topics: 16,16-Dimethylprostaglandin E2; Abortion, Missed; Adult; Carboprost; Dilatation and Curettage; Drug Evaluation; Female; Gestational Age; Humans; Hydatidiform Mole; Middle Aged; Pregnancy; Prostaglandins E, Synthetic; Prostaglandins F, Synthetic; Uterine Neoplasms; Uterus

Topics: Abortion, Incomplete; Abortion, Induced; Abortion, Missed; Adult; Carboprost; Female; Humans; Hydatidiform Mole; Injections, Intramuscular; Pregnancy; Prostaglandins F, Synthetic; Uterine Neoplasms

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

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

Eleven patients entered a multicentre trial of repeated intramuscular injections of 15(S)-15-methyl-prostaglandin F2 alpha (15-me-PGF2 alpha) for terminating molar pregnancy. Duration of pregnancy ranged from 9 to 24 (median: 16) weeks and uterine size from 15 to 24 (median: 19) weeks. Complete (n=5) or incomplete (n=4) expulsion of molar tissue occurred in 9 patients (82%) after a median duration of 15.7 hours. In the remaining 2 patients treatment was interrupted after 8 hours at a cervical dilatation of 1 cm or more. Gastro-intestinal side effects were prominent in 64%. The use of prostaglandins in the management of hydatidiform mole is discussed.. 11 cases of molar pregnancy terminated by repeated intramuscular injections of 15(S)-15-methyl prostaglandin F2 alpha (15-me-PGF2 alpha) are evaluated to determine the efficacy of this method of molar pregnancy management. Pregnancy durations were from 9-24 weeks (median, 16) and uterine size ranged from 15-24 weeks (median, 19). Since prompt evacuation of uterine contents is essential in cases of pathological pregnancy, especially of molar pregnancy which predisposes to severe hemorrhage, preeclampsia, and choriocarcinoma, the abortion time from injection to evacuation was measured. 82% of the patients (9 of 11) expelled the molar pregnancy after a median time of 15.7 hours; 5 of these were complete and 4 were incomplete expulsions. Treatment had to be interrupted in the other 2 patients after 8 hours and completed by cervical dilatation beyond the 1 cm provoked by injections and evacuation by mechanical means. 64% of patients suffered gastrointestinal side effects. A median of 5 injections was found, and numbers of injections for spontaneous expulsion ranged from 2-12. There was no relation between effectiveness of the prostaglandin analog or the induction-abortion interval and either the duration of pregnancy or uterine size. None of the patients required blood transfusion, and only 1 lost more than 500 ml of blood. Parous women received either doses of 250 mcg (n=2) or 125 mcg (n=2), whereas all nulliparous women received the 250 mcg dose every 2 hours.

Topics: Abortion, Therapeutic; Adult; Carboprost; Digestive System; Female; Humans; Hydatidiform Mole; Pregnancy; Prostaglandins F, Synthetic; Uterine Neoplasms

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