dinoprost and Cicatrix

To study the safety of second trimester abortion in women with previous uterine scar.. We screened the records of 518 women who underwent an abortion between 12 and 20 weeks' gestation at the Postgraduate Institute of Medical Education and Research, Chandigarh, India, from January 2000 to December 2010. Methods used for abortion were: (i) vaginal misoprostol with or without pre-treatment with mifepristone, and (ii) intracervical dinoprostol gel or vaginal misoprostol ± extra-amniotic saline ± oxytocin infusion. Seventeen women, aborted by means of a hysterotomy, were excluded from further analysis.. Of the remaining 501 women, 44 had a uterine scar (Group 1) and 457 had none (Group 2). In Group 1, 40/44 (91%) and in Group 2, 452/457 (99%) women aborted successfully. The mean induction-abortion interval (IAI) was similar in the two groups (15.03 ± 10.69 hours and 12.52 ± 9.0 hours in Groups 1 and 2, respectively; p = 0.083). There were three uterine ruptures, 1/44 (2%) in group 1 and 2/457 (0.4%) in group 2 (p = 0.132, NS); all three women had received mifepristone followed by vaginal misoprostol.. In women with a scarred uterus, midtrimester abortion may be successfully achieved using any of the aforementioned regimens.

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Induced; Adult; Case-Control Studies; Cicatrix; Developing Countries; Dinoprost; Female; Humans; India; Mifepristone; Misoprostol; Pregnancy; Pregnancy Trimester, Second; Retrospective Studies; Uterine Diseases; Uterine Rupture

This study has examined the effects of prostaglandins E2 and F2a (PGE2 and PGF2a) and indomethacin on cellular inflammation in fetal rabbits. Fetuses heal differently from adults: incisions heal with no scar or inflammation; excisional wounds exposed to amniotic fluid (AF) do not heal or become inflamed, and have high tissue levels of PGE2 and PGF2a; excisional wounds protected from AF do heal and become inflamed, and have low tissue PG levels. The authors inserted slow-release pellets [control, PGE2 (10 micrograms), PGF2a (10 micrograms), indomethacin (10 micrograms)] into subcutaneous pockets in fetal rabbits on day 25 of gestation (one per fetus). Pellets were also placed in subcutaneous pockets in the does. Fetuses and doe tissues were recovered 72 h after surgery. Control pellets in fetuses had a slight inflammatory response, with some cells present. Fetal PGE2 pellets had a layer 5-10 cells thick surrounding the pellet, and fetal PGF2a pellets had a 10-15-cell layer. Fetal indomethacin pellets had no response, with no inflammatory cells present. All pellets placed in does elicited a slight cellular inflammatory response, equal to that seen with control pellet in fetuses. These results show that PGE2 and PGF2a are potent in-vivo promoters of cellular inflammation in fetal rabbits, but not in adult rabbits. Indomethacin suppresses the foreign-body response in fetal rabbits, but not in adult rabbits.

Topics: Animals; Cicatrix; Delayed-Action Preparations; Dinoprost; Dinoprostone; Drug Implants; Female; Fetus; Indomethacin; Inflammation; Prenatal Injuries; Rabbits; Wound Healing