dinoprost and Uterine-Inertia

Topics: Dinoprost; Dinoprostone; Female; Humans; Menstruation-Inducing Agents; Pregnancy; Puerperal Disorders; Uterine Inertia

Topics: Dinoprost; Dinoprostone; Dose-Response Relationship, Drug; Female; Humans; Postpartum Hemorrhage; Pregnancy; Prostaglandins; Prostaglandins E, Synthetic; Prostaglandins F, Synthetic; Puerperal Disorders; Uterine Inertia

Topics: Adrenergic beta-Antagonists; Adult; Dinoprost; Dinoprostone; Female; Humans; Oxytocin; Pregnancy; Prostaglandins E; Prostaglandins F; Uterine Inertia

Normal labor is accompanied by sequential changes in blood concentrations of prostaglandin F2alpha (measured as 15-ketodihydro-PGF2 alpha=PGFM), progesterone, estradiol, oxytocin, vasopressin, and of elevated cortisol levels. The aim of this study was to investigate hormone concentrations in dogs diagnosed with primary uterine inertia before and during treatment by cesarean section. The hypothesis was the dogs would have abnormally low plasma concentrations in one or several of the hormones involved in parturition. The study comprised seven bitches with total primary uterine inertia (dystocia group) treated with cesarean section and six healthy bitches (control group) subjected to planned cesarean section. Blood samples were taken before anesthesia, before surgery started, on delivery of the first puppy and on delivery of the last puppy. The progesterone:PGFM ratio in plasma was higher in the dystocia group than in the control group, but the serum estradiol concentration did not differ between groups. The plasma concentrations of oxytocin and vasopressin increased in both groups when the first puppies were delivered, but both hormones were more elevated in the control group than in the dystocia group on delivery of the last puppies. The plasma cortisol concentration increased to the same level in both groups. In conclusion, the ratio between progesterone and PGFM was higher and the oxytocin and vasopressin concentrations lower in the dystocia dogs than in the control dogs. The findings indicate that these hormones are involved in the pathophysiology of total primary uterine inertia in bitches.

Topics: Animals; Cesarean Section; Dinoprost; Dogs; Female; Hormones; Hydrocortisone; Osmolar Concentration; Oxytocin; Pregnancy; Pregnancy, Animal; Uterine Inertia; Vasopressins

To investigate the interaction of exogenous adenosine 5'-triphosphate (ATP), a P2 receptor agonist, with prostaglandin F(2alpha) (PGF(2alpha)) on pregnant women in labor as well as on isolated human pregnant uterus preparations.. For an in vitro study, myometrial samples were obtained from 27 women undergoing elective cesarean delivery at term. Concentration-response relationships for ATP (10(-8) -3 x 10(-4) mol/L), PGF(2alpha) (10(-9) -10(-5) mol/L), and their combination were obtained by using routine pharmacological organ bath technique. An in vivo study was performed with 34 pregnant women with dysfunctional abnormalities of the active stage of labor who were randomly allocated into 2 study groups. The women in the control group (18 patients) received intravenous prostaglandin F(2alpha) at an initial rate of 7.5 mug/min, whereas the women in the ATP group (16 patients) received prostaglandin F(2alpha) concomitantly with ATP (0.45 nmol/min, intravenously).. Adenosine 5'-triphosphate at concentrations of 10(-6) -3 x 10(-4) mol/L and PGF(2alpha) at concentrations of 10(-8) -10(-5) mol/L caused concentration-dependent contractions of isolated smooth muscle preparations of the human pregnant uterus. At concentrations of 10(-6) mol/L and below, ATP had no effects on mechanical activity of the isolated uterus, but at concentrations of 10(-7) mol/L and 10(-6) mol/L, it significantly potentiated the contractile responses of the uterus induced by PGF(2alpha) (P < .05, 2-way analysis of variance). Patients receiving intravenous infusion of ATP as a supplement to PGF(2alpha) treatment, compared with those without ATP, had a significantly shorter interval from the start of the treatment to full cervical dilatation (3.31 +/- 1.49 hours and 4.67 +/- 1.11 hours in ATP and control groups, respectively; P = .014, Wilcoxon Mann-Whitney test). The total dose of prostaglandin received was significantly lower in the ATP group than that of controls (1,489.8 +/- 699.9 mug and 3,394.2 +/- 1,951.9 mug, respectively; P = .003, Wilcoxon Mann-Whitney test). No side effects of ATP treatment were observed during or after infusion.. Adenosine 5'-triphosphate potentiates effects of PGF(2alpha) on pregnant human uterus in vitro and in vivo and thus could be a useful supplemental drug to increase uterine contractility at labor.

Topics: Adenosine Triphosphate; Dinoprost; Drug Synergism; Female; Humans; In Vitro Techniques; Pregnancy; Purinergic P2 Receptor Agonists; Uterine Contraction; Uterine Inertia; Uterus

Severe postpartum hemorrhage is a significant contributor to maternal morbidity and mortality. The use of prostaglandin F2-alpha to control severe postpartum hemorrhage may avert surgery for the control of bleeding.. After ruling out the possibility of genital tract injuries, 18 patients with severe postpartum hemorrhage caused by uterine atony were enrolled in the study. None of the patients responded to treatment with oxytocin, methylergonovine, or uterine massage. A Foley catheter was introduced into the uterine cavity and the balloon was inflated with 5 ml sterile saline solution. The catheter was connected to an infusion line of 500 ml saline solution containing 20 mg prostaglandin F2-alpha. The solution was infused at a rate of 3-4 ml/minute for the first 10 min, and then reduced to 1 ml/minute for a period of 12 24 hours.. In 17 patients (94.4%) bleeding ceased within several minutes of initiation of intrauterine prostaglandin F2-alpha infusion, the uterus was firmly contracted and uterine bleeding did not recur. In one patient with placenta increta bleeding continued and hysterectomy was performed. None of the patients had any side effects.. Intrauterine irrigation with low concentrations of prostaglandin F2-alpha is a simple, rapid and effective treatment for severe postpartum hemorrhage and facilitates constant and continuous hemostasis. Moreover, the minute dosage used eludes potentially complicating side effects.

Topics: Dinoprost; Female; Humans; Postpartum Hemorrhage; Pregnancy; Therapeutic Irrigation; Treatment Outcome; Uterine Inertia; Uterus

Postpartum atony remains the most common cause life-threatening haemorrhage in obstetrics. In a case of postpartum atony unresponsive to medical treatment after Caesarean section haemorrhage was controlled and satisfactory uterine tonus was achieved by inverted sutures of the uterine fundus. Imminent hysterectomy could thus be avoided.

Topics: Adult; Cesarean Section; Combined Modality Therapy; Dinoprost; Ergonovine; Female; Humans; Oxytocin; Postpartum Hemorrhage; Pregnancy; Pregnancy, Prolonged; Sutures; Uterine Inertia

In the authors' group of patients with haemorrhage during childbirth, in 1990-1994 a total of 28 atonic haemorrhages were recorded, 15 of them were controlled by uterotonic treatment, in the remaining 13 cases haemostasis using PG F2 alpha was applied after ruling out post-partum injury. Some patients were given moreover saline infusions. According to initial results and consistent with the literature analogues of PG F2 alpha are effective uterotonic preparations of a new generation. With regard to their simple and rapid administration they are becoming the drug of first aid in the treatment of acute atonic haemorrhage.

Topics: Dinoprost; Female; Humans; Postpartum Hemorrhage; Pregnancy; Uterine Inertia

A woman underwent cesarean delivery for premature labor, breech presentation, and ruptured membranes. Placenta accreta associated with uterine atony and severe hemorrhage was diagnosed. Prostaglandin E1 instead of prostaglandin F2 alpha was inadvertently administered in an effort to control the hemorrhage. The resulting complications included profound hypotension, disseminated intravascular coagulation, and ventricular tachycardia.

Topics: Adult; Alprostadil; Dinoprost; Female; Humans; Medication Errors; Obstetric Labor, Premature; Placenta Accreta; Pregnancy; Uterine Hemorrhage; Uterine Inertia

Topics: Contraindications; Dinoprost; Female; Humans; Pregnancy; Puerperal Disorders; Uterine Inertia

The authors report on five cases of massive atonic uterine haemorrhage which could be influenced neither by repeated application of oxytocin nor by methylergometrin. Intramyometrial application of PGF2 alpha succeeded in inducing a satisfactory uterine tone and stopping the haemorrhage. With regard to own experiences and data from only few publications dealing with the use of prostaglandin in atonic haemorrhage, the authors consider transvaginal intramyometrial application of PGF2 alpha to be an effective method to circumvent an emergency hysterectomy. However, this should occur sufficiently early and in a dose of not less than 1 mg.

Topics: Abortion, Induced; Adult; Dinoprost; Female; Humans; Myometrium; Postpartum Hemorrhage; Pregnancy; Prostaglandins F; Uterine Inertia; Uterine Perforation

The influence of dose of oxytocin and the interval between prostaglandin (PG) F2 alpha and oxytocin administration on the synchrony of farrowing, the prevalence of intrapartum complications, and the number of pigs dying perinatally was investigated. In study 1, sows were given 10 mg of PGF2 alpha IM on day 112, 113, or 114 of gestation or were not treated. Twenty hours after PGF2 alpha administration, sows were given 0, 5, 10, 20, or 30 USP U of oxytocin IM. Sows treated with PGF2 alpha or PGF2 alpha plus oxytocin had a shorter interval to farrowing than sows not treated or treated with oxytocin alone. Treatment with PGF2 alpha plus 30 U of oxytocin induced the most rapid onset and the greatest synchrony of farrowing, with the mean onset occurring 2.1 +/- 0.4 hours after oxytocin vs greater than 8 hours for all other treatments. Sows treated with 5 or 10 U of oxytocin had a delayed onset and a less synchronous farrowing, compared with sows treated with 0 or 20 U. Day of PGF2 alpha treatment influenced (P less than 0.05) the interval from oxytocin to onset of farrowing. As day during gestation decreased, there was a corresponding decrease in the interval between oxytocin administration and farrowing. Number of interventions to remove retained pigs was not influenced (P greater than 0.05) by day of PGF2 alpha administration. All sows treated with PGF2 alpha followed by oxytocin had a higher rate of manual interventions, compared with that in sows given PGF2 alpha but not oxytocin.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Dinoprost; Drug Administration Schedule; Female; Labor, Induced; Labor, Obstetric; Obstetric Labor Complications; Oxytocin; Pregnancy; Prostaglandins F; Swine; Swine Diseases; Time Factors; Uterine Inertia

Topics: Dinoprost; Female; Humans; Postpartum Hemorrhage; Pregnancy; Prostaglandins F; Uterine Inertia

Five patients with severe postpartum hemorrhage due to uterine atony and unresponsive to oxytocin, ergonovine, and massage were treated with intramyometrial injection of 250 micrograms of prostaglandin (15S)-15-methyl PGF2 alpha-Tham. Four patients received 2 injections (500 micrograms), and 1 patient required 1 injection (250 micrograms). Three (60%) of 5 patients responded successfully with an increase in uterine tone and cessation of uterine hemorrhage, thus obviating the need for hysterectomy. Two patients had no uterine response, possibly because of delayed use of the drug, excessive blood loss, and accompanying shock; they required hysterectomy. Intramyometrial injection of prostaglandin is an effective and safe method of managing severe postpartum hemorrhage unresponsive to oxytocin and ergonovine, but it must be used early during the management of atony to obtain maximum effect. This method should precede surgical management of uterine atony.

Topics: Adolescent; Adult; Cesarean Section; Dinoprost; Female; Humans; Injections, Intramuscular; Myometrium; Postpartum Hemorrhage; Pregnancy; Prostaglandins F; Uterine Inertia