oxytocin and Abortion--Missed

Prostaglandin F2a was used for termination of pregnancy in two groups of patients. The first included eighteen patients with either missed abortion or intrauterine fetal death, and were treated by intrauterine-extraamniotic infusion of 20 mg prostaglandin F2a. The treatment was successful in 14 patients (mean induction-abortion interval 6.7 hours). Four patients, where the above method failed to induce labor, were given intravenously prostaglandin F2a or oxytocin simultaneously or separately; the expulsion time ranged from 12 to 48 hours. The second group included twelve patients who underwent a therapeutic abortion following either a diagnosis of fetal congenital abnormality or because of a maternal indication. The therapeutic abortion was performed using prostaglandin F2a (25-40 mg) via amniocentesis. The treatment was successful in all patients (mean induction-delivery interval 10.6 hours).

Topics: Abortion, Missed; Abortion, Therapeutic; Amniotic Fluid; Dinoprost; Drug Administration Schedule; Drug Evaluation; Drug Therapy, Combination; Female; Fetal Death; Humans; Labor, Induced; Oxytocin; Pregnancy; Pregnancy Trimester, Second; Retrospective Studies; Time Factors

Topics: Abortion, Missed; Calcium Channel Blockers; Female; Humans; In Vitro Techniques; Nifedipine; Obstetric Labor, Premature; Oxytocin; Pregnancy; Uterine Contraction

To study the effect of mifepristone for priming and induction of second-trimester abortion in conjunction with a high-concentration oxytocin drip.. Prospective, randomized, placebo-controlled, pilot study. Thirty patients with 14-25 weeks' gestational age abortion received either 600 mg of mifepristone or placebo in 3 identical capsules followed, 48 hours later, by a high-concentration oxytocin drip (HCOD).. The mifepristone group showed significantly higher success rates as compared to the placebo group (92.3% vs. 52.9%, p<0.05). The time interval to abortion (from beginning of HCOD) was also significantly shorter in the mifepristone group as compared to the placebo group (11.3 +/- 6.0 hours vs. 17.6 +/- 6.5 hours, p <0.05). Probability of success as calculated by the Kaplan-Meier method was found to be highly significant (log rank test p = 0.001).. Our results suggest that mifepristone is very effective for priming and induction of second-trimester abortion and shortens significantly the time interval to evacuation following HCOD.

Topics: Abortifacient Agents; Abortion, Induced; Abortion, Missed; Administration, Oral; Adult; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Infusions, Intravenous; Kaplan-Meier Estimate; Mifepristone; Oxytocin; Pilot Projects; Placebos; Pregnancy; Pregnancy Trimester, Second; Young Adult

Termination of pregnancy in missed abortion and intra-uterine fetal death was accomplished using vaginal suppositories of 20 mg PGE2 in 31 cases and the results were compared with oxytocin induction (with or without estrogen pre-treatment) in 17 cases at the doses routinely used in our hospital. The PG suppositories proved much more superior (96.7%) than oxytocin (47.7%), but induced a higher rate of side effects. The latter were not serious and were generally tolerated by the patients. There was a positive correlation between duration of fetal retention in utero and the induction expulsion time. The over all patient acceptance of the method was quite favourable and the approach appears to be a definite advance towards management of these cases.

Topics: Abortion, Missed; Drug Evaluation; Female; Fetal Death; Humans; Labor, Induced; Oxytocin; Pregnancy; Prostaglandins E; Suppositories; Time Factors

Oxytocin is commonly used to reduce blood loss during suction curettage for missed abortion. However, the potential of oxytocin to mitigate blood loss in early pregnancy remains controversial. Based on the hypothesis that the "timing" of oxytocin administration may be a critical factor, we investigated whether the timing of intravenous (IV) administration is associated with reduced perioperative blood loss during first-trimester suction curettage for missed abortion.. The medical charts of 146 patients with ultrasound-confirmed first-trimester missed abortion who underwent suction curettage with IV oxytocin administration were retrospectively reviewed.. Among the patients, 67 received 10 IU of IV oxytocin before suction curettage (early-oxytocin administration group), while 79 patients received 10 IU of IV oxytocin after suction curettage (late-oxytocin administration group). The demographic features between the two groups did not significantly differ. However, there was a lower proportion of nulliparous patients in the early-oxytocin administration group than in the late-oxytocin administration group (38.8% vs 60.8%, p = 0.006). The perioperative blood loss amount was significantly lower in the early-oxytocin administration group than in the late-oxytocin administration group (60 [range: 50-100] vs 100 [range: 30-250] mL, p = 0.001). Moreover, the multivariate logistic regression analysis showed that the early-oxytocin administration group had a lower risk for a perioperative blood loss amount of ≥100 mL than the late-oxytocin administration group (0.23 [range: 0.10-0.55], p = 0.001); a gestational age of 9-12 weeks ( p = 0.009) was found to be associated with an increased risk for a perioperative blood loss amount of ≥100 mL.. Compared with late-oxytocin administration, early-oxytocin administration could reduce perioperative blood loss during first-trimester suction curettage for missed abortion. However, the results require further investigation.

Topics: Abortion, Induced; Abortion, Missed; Blood Loss, Surgical; Female; Humans; Infant; Oxytocin; Pregnancy; Pregnancy Trimester, First; Retrospective Studies; Vacuum Curettage

Extra-amniotic infusion of prostaglandin F2 alpha (PGF2 alpha) and intravenous (IV) oxytocin in increasing doses were compared in a retrospective study to establish the efficacy of the two methods for termination of pregnancies with second trimester missed abortion. Sixty women with this complication underwent pregnancy termination, 28 by extra-amniotic infusion of PGF2 alpha and oxytocin augmentation, if necessary, and 32 by IV oxytocin in increasing doses. All patients in the PGF2 alpha group aborted within 24 hours from onset of infusion and seven of them needed oxytocin augmentation. There were nine failures in the oxytocin group and the other 23 aborted within 17 hours. The mean (plus or minus standard error of the mean) induction-abortion interval was significantly less in the oxytocin group (6.9 +/- 3.4 hours) than in the PGF2 alpha group (12.6 +/- 5.7 hours) p < 0.001. Eight patients in the group had mild side effects, such as nausea, flushes or transient hypotension. Uterine hypertonus was observed in two women receiving PGF2 alpha and treated by temporary interruption of the infusion. In the oxytocin group, one patient had coagulation disturbances and one, hemorrhage. We conclude that extra-amniotic PGF2 alpha infusion is more effective than IV oxytocin in increasing doses, for termination of second trimester missed abortion, but takes effect more slowly. We can assume that further use of IV oxytocin immediately after termination of the PGF2 alpha administration can shorten the induction-abortion interval.

Topics: Abortion, Missed; Adult; Dinoprost; Female; Humans; Infusions, Intravenous; Oxytocin; Pregnancy; Pregnancy Trimester, Second; Retrospective Studies

Topics: Abortion, Missed; Abortion, Therapeutic; Adult; Dinoprost; Female; Fetal Death; Humans; Labor, Induced; Oxytocin; Pregnancy; Prostaglandins F

Topics: Abortion, Missed; Female; Humans; Male; Oxytocin; Pregnancy; Sodium; Water Intoxication

Abortifacient effects of 16,16-dimethyl-trans delta 2-PGE1 methyl ester (ONO-802) were studied clinically. The uterine contractile effect of the agent was compared with those of PGF2 alpha and oxytocin (OXY) in the unanesthetized rabbit. 1. Intermittent intravaginal administration of ONO-802 was applied to 32 cases of legal abortion, 15 of missed abortion and 17 of hydatid mole. Eighty eight, 100 and 81 per cent of these patients resulted in abortion, respectively, with fewer side effects than those of natural PGs. 2. In the five groups of non- or pseudo-pregnant rabbits and those in their 7-9, 14-16 and 19-28 days in pregnancy, uterine contractile effects of these agents were assessed by both the contractile patterns and area of contractile curves of initial 5 minutes. The results are as follows: 1) In the non-pregnant rabbits, all of these agents revealed marked uterine contractile effect. 2) ONO-802 induced uterine contraction characterized by its wedge-shaped curves continued considerably longer than that induced by others. 3) ONO-802 revealed much stronger effect on uterine contraction in 7-9 day-of-pregnant rabbits. 4) Fourteen-16-day-of-pregnant rabbits were least influenced by the three agents as regards their uterine contraction in accordance with the highest progesterone levels in their sera among the three groups of pregnant rabbits.

Topics: Abortion, Missed; Abortion, Therapeutic; Alprostadil; Animals; Dinoprost; Female; Humans; Oxytocin; Pregnancy; Prostaglandins E, Synthetic; Prostaglandins F; Rabbits; Uterine Contraction; Uterine Hemorrhage

In cases of missed abortion and missed labor, labor was induced by PGF2 alpha i.a., i.v. and by oxytocin infusion. Platelet function (methods of Born and Breddin), the coagulation system and fibrinolysis have been studied within the three groups. Using PGF 2 alpha i.v., the initially increased platelet aggregation showed a tendency to become normal. There was no manifestation of activation of the coagulation system. Fibrinolytic activity showed a slight increase during PGF2 alpha i.v. No essential changes in platelet function, coagulation and fibrinolytic system were found after i.a. injection of PGF2 alpha. When inducing labor by oxytocin i.v., both the coagulation and the fibrinolytic system were slightly activated and platelet aggregation increased. The results and their clinical importance for hemostasis as well as therapeutic consequences are discussed.

Topics: Abortion, Missed; Blood Coagulation; Female; Fibrinolysis; Humans; Injections, Intra-Arterial; Injections, Intravenous; Labor, Induced; Obstetric Labor Complications; Oxytocin; Platelet Aggregation; Pregnancy; Prostaglandins F

Labor was successfully induced in 20 patients with a diagnosis of missed abortion or intrauterine fetal death (IUFD) by intravaginal administration of prostaglandin E2 suppositories. Fifteen patients delivered with the prostaglandin alone while a concomitant oxytocin infusion was employed to augment contractions in the other five patients. The mean induction-delivery time was 9.80 hours; nulliparous patients delivered in a mean time if 7.78 hours, parous patients in a mean time of 12.29 hours. The uterus appeared to be sensitive to the PGE2 stimulation in all patients and all were delivered completely without the need for surgical intervention. Fifty per cent of patients were delivered within 8 hours and 80 per cent by 12 hours. The side effects associated with prostaglandin administration--vomiting, diarrhea, and temperature elevation--were well tolerated and therapy did not have to be terminated in any patient. The administration of PGE2 vaginal suppositories offers an effective and safe technique for the induction of labor in patients with IUFD. Labor can be induced with PGE2 suppositories as soon as the diagnosis of IUFD is confirmed, which eliminates the need for waiting until spontaneous labor occurs.

Topics: Abortion, Missed; Adolescent; Adult; Female; Fetal Death; Humans; Labor, Induced; Oxytocin; Pregnancy; Prostaglandins E; Suppositories; Time Factors

Intramuscular injections of 15(S)-15-methyl prostaglandin F2alpha (15-Me-PGF2alpha) induced abortion in 38 patients who had failed to abort with other techniques, such as intra-amniotic instillation of saline or PGF2alpha and intravaginal insertion of prostaglandin-impragnated Silastic devices. The intramuscular injections of 15-Me-PGF2alpha were initiated when the original abortion techniques, even when augmented by intravenous oxytocin, failed to produce expulsion of the fetus. The dose schedule was 250 microgram or 500 microgram every 2 to 4 hours, and the concomitant intravenous oxytocin was continued at a rate of 167 mU/minute. Of the 38 patients, 26 aborted with two or fewer injections of 15-Me-PGF2alpha, and 30 patients required only 1 mg of the drug to expel the fetus successfully. The mean time from the first injection of 15-Me-PGF2alpha to the expulsion of the fetus was 5.25 hours; one-half of the patients aborted in less than 4 hours. The placenta was expelled spontaneously in 15 patients, removed manually from the vagina in 18, and removed by sponge forceps in 3. Two abortions were incomplete and surgical intervention was required. Twenty-eight patients (74%) experienced gastrointestinal disturbances, chiefly vomiting and diarrhea. Intramuscular administration of 15-Me-PGF2alpha eliminates the need for repeated amniocentesis, and the dose may be adjusted to meet the precise requirements of the clinical situation.

Topics: Abortion, Induced; Abortion, Missed; Abortion, Spontaneous; Female; Humans; Oxytocin; Pregnancy; Prostaglandins F, Synthetic

In a group of 16 women admitted for missed abortion, missed labor or antepartum fetal death, we induced abortion or labor by means of extraamniotic infusion of isotonic saline solution, using a Foley catheter inserted through the cervix. Eight patients also required parallel intravenous administration of 5-10 U of oxytocin drip. The average time from the onset of treatment until expulsion of the macerated fetus was 9.09 hours. No complications were recorded. This method is suggested in all such cases, especially when the classical methods are contraindicated.

Topics: Abortion, Induced; Abortion, Missed; Adult; Female; Fetal Death; Humans; Isotonic Solutions; Labor, Induced; Oxytocin; Pregnancy; Pregnancy Complications; Sodium Chloride

Extraamniotic PGE2 and iv oxytocin in termination of midtrimester pregnancy and in the management of missed abortion and hydatiform mole are reported. 18 patients were divided into 2 groups: 1) 12 patients received an initial dose of 200 mcg of PGE2 and subsequent instillations of 100-200 mcg/hour. If abortion was not achieved in 12 hours, oxytocin was started. 2) 6 patients received an initial dose of 500 mcg of PGE2 and subsequent instillations with 500 mcg at 4, 6, and 8 hours, respectively. If abortion was not achieved by 6 hours, oxytocin was started. Abortion was achieved in all patients; 15 within 24 hours. Comcomitant administration of extraamniotic PGE2 and iv oxytocin was shown to be a safe and efficient way of inducing midtrimester abortion, missed abortion, and hydatiform mole. This methods is associated with minimum side effects and complications.

Topics: Abortion, Induced; Abortion, Missed; Adolescent; Adult; Female; Humans; Hydatidiform Mole; Injections, Intravenous; Oxytocin; Pregnancy; Pregnancy Trimester, Second; Prostaglandins E

In a group of 84 women in the second trimester of pregnancy abortion was induced by intramniotic transabdominal instillation of 20 per cent NaCl. In a second group of 91 women the abortion was induced by means of extraamniotic physiological infusion of saline solution. The only complication observed in the first group was an increasing fever. In the second group there were better results. The fetus abortion was complete and in a shorter time. We assume that the new method is the method of choice because it gives no complications and may be easily performed. It may be used also in cases of missed abortion or intrauterine fetal death.. In a group of 84 women in the 2nd trimester of pregnancy, abortion was induced by intraamniotic transabdominal instillation of 20% NaCl. In a 2nd group of 91 women abortion was induced using extraamniotic physiological infusion of saline solution. The only complication observed in the 1st group was an increasing fever. In the 2nd group there were better results: fetus abortion was complete and in a shorter time. It is assumed that the new method is the method of choice because it gives no complications and may be easily performed. It may be used also in cases of missed abortion or intrauterine fetal death.

Topics: Abortion, Induced; Abortion, Missed; Adolescent; Adult; Female; Fetal Death; Fever; Humans; Oxytocin; Pregnancy; Pregnancy Trimester, Second; Saline Solution, Hypertonic; Sodium Chloride

Topics: Abortion, Missed; Chemical Phenomena; Chemistry; Female; Humans; Hydatidiform Mole; Labor, Induced; Myometrium; Oxytocin; Pregnancy; Prostaglandins F

Compared to conventional methods, therapeutic abortion up to the 12th week of gestation by the extraamnial administration of (PG) prostaglandin is undesirable because of the long-term treatment necessary and because of the danger of ascending infection. However, in cases of late therapeutic abortion, missed abortion, and hydatidiform mole, the administration of PG is the method of choice. Continuous monitoring of the intrauterine pressure during intermittent administration of PG in dosages which do not unduly prolong the time of therapy shows pathological patterns of contractions due to overstimulation of the uterus. Initial uterine tetany then shows discoordination of the contractions, high frequency of the contractions, and during the 2nd stage, excessively high intrauterine pressures. It is therefore necessary to individualize the dosage of PG according to the uterine response measured by continuous monitoring of the intrauterine pressures. (author's modified)

Topics: Abortion, Induced; Abortion, Missed; Female; Gestational Age; Humans; Hydatidiform Mole; Oxytocin; Pregnancy; Pressure; Prostaglandins; Time Factors; Uterus

Topics: Abortion, Missed; Acupuncture Therapy; Adult; Electric Stimulation; Female; Fetal Death; Humans; Labor, Induced; Labor, Obstetric; Methods; Needles; Oxytocin; Physical Stimulation; Pregnancy; Pregnancy, Prolonged; Rotation; Time Factors; Uterus

Topics: Abortion, Induced; Abortion, Missed; Blood Pressure; Female; Fetal Death; Fever; Gestational Age; Humans; Hydatidiform Mole; Infusions, Parenteral; Oxytocin; Pregnancy; Prostaglandins; Pulse; Ultrasonics

Topics: Abortion, Missed; Abortion, Septic; Abortion, Spontaneous; Abortion, Threatened; Ambulatory Care; Anti-Bacterial Agents; Curettage; Diagnosis, Differential; Female; Humans; Oxytocin; Pregnancy; Pregnancy, Tubal; Time Factors

Topics: Abortion, Missed; Female; Gestational Age; Humans; Injections, Intravenous; Oxytocin; Parity; Pregnancy; Uterine Rupture

Topics: Abortion, Missed; Adult; Female; Gestational Age; Humans; Hysterectomy; Infusions, Parenteral; Oxytocin; Pregnancy; Uterine Rupture

Topics: Abortion, Missed; Adult; Estrogens; Female; Humans; Labor, Induced; Oxytocin; Pregnancy; Uterus

Topics: Abortion, Missed; Abortion, Spontaneous; Delivery, Obstetric; Female; Humans; Obstetric Labor, Premature; Oxytocin; Pregnancy; Pregnancy Complications

Topics: Abortion, Missed; Adult; Electroencephalography; Female; Humans; Oxytocin; Pregnancy; Prognosis; Seizures; Water Intoxication

Topics: Abortion, Legal; Abortion, Missed; Adolescent; Adult; Alkaloids; Curettage; Female; Humans; Oxytocin; Pregnancy; Uterine Hemorrhage; Uterine Rupture

Topics: Abortion, Missed; Adolescent; Adult; Age Factors; Curettage; Female; Geography; Humans; Middle Aged; Oxytocin; Parity; Pregnancy; Retrospective Studies; White People

Topics: Abortion, Missed; Estrogens; Female; Humans; Oxytocin; Pregnancy

Topics: Abortion, Missed; Adult; Female; Humans; Injections, Intravenous; Oxytocin; Pregnancy

Topics: Abortion, Missed; Biomedical Research; Castration; Cats; Drug Therapy; Electromyography; Estrogens; Female; Humans; Metabolism; Ovary; Oxytocin; Pharmacology; Placental Hormones; Pregnancy; Pregnancy, Animal; Pregnanediol; Progesterone; Rabbits; Rats; Stilbenes; Uterus

Topics: Abortion, Missed; Adult; Female; Humans; Hypertonic Solutions; Oxytocin; Pregnancy

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Abortion, Missed; Blood; Diuresis; Electrolytes; Female; Humans; Labor, Induced; Oxytocin; Polycystic Ovary Syndrome; Pregnancy; Urine

Topics: Abortion, Induced; Abortion, Missed; Female; Humans; Labor, Induced; Labor, Obstetric; Oxytocin; Pharmacology; Pregnancy; Toxicology

Topics: Abortion, Habitual; Abortion, Induced; Abortion, Missed; Abortion, Septic; Abortion, Spontaneous; Abortion, Therapeutic; Abortion, Threatened; Cervix Uteri; Classification; Ergonovine; Female; Humans; Hydroxyprogesterones; Norethindrone; Oxytocin; Pathology; Pregnancy; Progesterone; Rest

Topics: Abortion, Induced; Abortion, Missed; Abortion, Spontaneous; Abortion, Therapeutic; Drug Therapy; Female; Humans; Hydatidiform Mole; Oxytocin; Pregnancy; Uterine Neoplasms

Topics: Abortion, Induced; Abortion, Missed; Abortion, Spontaneous; Blood Coagulation Disorders; Female; Humans; Oxytocin; Pregnancy

Topics: Abortion, Induced; Abortion, Missed; Abortion, Spontaneous; Female; Humans; Oxytocin; Perfusion; Pregnancy

Topics: Abortion, Induced; Abortion, Missed; Abortion, Spontaneous; Female; Humans; Hydatidiform Mole; Oxytocics; Oxytocin; Pregnancy; Uterine Neoplasms

Topics: Abortion, Induced; Abortion, Missed; Abortion, Spontaneous; Female; Humans; Infusions, Intravenous; Injections; Injections, Intravenous; Oxytocin; Pregnancy

Topics: Abortion, Induced; Abortion, Missed; Abortion, Spontaneous; Female; Humans; Infusions, Intravenous; Oxytocics; Oxytocin; Pregnancy

18 cases of missed abortion occurring during or after the 12th week of gestation in Professor Kellar's Unit of the Simpson Memorial Maternity Pavilion during the past 3 years were managed using intravenous high concentration oxytocin drips. Estimated duration of fetal death ranged from 3 to 14 weeks. A summary of the results of analysis is presented in Table 1. Delivery was achieved in the last 13 cases (except 2) within 24 hours of treatment. Of the 2 exceptions, 1 patient in whom the fetus had been dead for the longest time (14 weeks) took 31 1/4 hours to pass the fetus; the other patient took 21 1/4 hours to pass the fetus but as the placenta failed to follow, another drip was administered 11 hours later. The placenta was passed 50 minutes later. Surgical evacuation of the uterus was performed in 7 patients to complete the abortion process. No evidence of failure of clotting mechanism after delivery was observed, nor was the possibility of toxic substances being introduced into the maternal circulation from the placenta seen. It was concluded that the use of oxytocin drips is a reliable, rapid and safe method of managing missed abortion.

Topics: Abortifacient Agents; Abortion, Induced; Abortion, Missed; Abortion, Therapeutic; Age Factors; Biology; Contraception; Demography; Endocrine System; Family Planning Services; Female; Fetal Death; Hormones; Humans; Infusions, Intravenous; Mortality; Oxytocin; Physiology; Pituitary Hormones; Population; Population Dynamics; Pregnancy