dinoprost and Hydatidiform-Mole

Prostaglandins (PG) are currently the drugs of choice to terminate pathological 2nd trimester pregnancies. 6 different dose schedules of were are tested in 100 women with missed abortion, hydatidiform mole, and fetal malformations: extraamniotic PGF2 alpha, intravenous PGE2, intravenous sulprostone (2 schedules), and intramuscular sulprostone (2 schedules). All tested regimens were effective. Induction-to-abortion times and incidence of side effects were different. Extraamniotic PGF2 alpha and intramuscular sulprostone appear to be the most practicable regimens.

Topics: Abortion, Missed; Congenital Abnormalities; Dinoprost; Dinoprostone; Female; Humans; Hydatidiform Mole; Infant, Newborn; Injections, Intramuscular; Injections, Intravenous; Labor, Induced; Pregnancy; Pregnancy Trimester, Second; Prostaglandins; Prostaglandins E; Prostaglandins E, Synthetic; Prostaglandins F

We experienced a case of myocardial infarction associated with pulmonary edema in a patient with hydatidiform mole probably due to methylergometrin and prostaglandin F2 alpha (PGF2 alpha) administered during the operation. A 26-year-old woman was scheduled to have curettage for hydatidiform mole under general anesthesia. She had no previous history of cardiopulmonary disease. During the operation, 0.4 mg of methylergometrin was administered intravenously to induce uterine contraction. Because the contraction was not sufficient, 2 mg of PGF2 alpha was given into the uterine muscle. A few minutes later blood pressure and heart rate increased abruptly and arterial blood gas analysis showed hypoxia and respiratory acidosis. Pulmonary edema was confirmed by chest X-P. After ordinary treatment for pulmonary edema, she was transferred to ICU. Postoperative examinations of ECG, serum enzymes and echocardiography revealed anterior subendocardial infarction. About one month later, methylergometrin test was performed during coronary angiography and this induced coronary vasospasm. PGF2 alpha is also known to cause peripheral as well as pulmonary vasoconstriction. Acute myocardial infarction induced by methylergometrin and PGF2 alpha may be a possible cause of this episode.

Topics: Adult; Curettage; Dinoprost; Female; Humans; Hydatidiform Mole; Methylergonovine; Myocardial Infarction; Pregnancy; Pulmonary Edema