sulprostone and Fetal-Death

A 30-year old pregnant woman who had had an earlier stillbirth and 2 children, the oldest of whom was delivered by Cesarean section, presented at the National University Hospital in Singapore at 32 weeks because she had not felt fetal movements for 3 days. Doptone did not detect a fetal heart beat and ultrasound confirmed intrauterine death. She did not have any soreness at the previous lower segment Cesarean scar. After she opted to have labor induced, health workers injected 0.5 mg of the prostaglandin E2 analogue, sulprostone, into a muscle every 6 hours. Painful uterine contractions did not start until after the 2nd injection of sulprostone. 20 hours after the 1st injection, her pulse increased to 100/minute, blood pressure fell from 120/70 to 80/50, and she began to perspire. She noted tenderness at the lower segment scar. Abdominal examination did not reveal any free fluid. There was no blood in the urine. 20 minutes after her blood pressure increased to 100/70, the woman had steady abdominal pain and vaginal bleeding. Her abdomen swelled and rebound tenderness occurred. Physicians diagnosed uterine rupture and performed a laparotomy promptly. They found 800 ml of free blood in the peritoneal cavity and a complete rupture all along the Cesarean scar. The removed the dead fetus and repaired the scar. They also applied Filshie clips on her Fallopian tubes since she wanted to be sterilized. She was discharged 7 days after laparotomy and recovered uneventfully. This case report confirms that vaginal delivery at term after lower segment Cesarean section is no guarantee against scar rupture in subsequent pregnancies, particularly when health workers use prostaglandins. Nevertheless, prostaglandins are still a reasonably safe and predictable method of terminating pregnancy even in cases of previous Cesarean section. It is important that health workers supervise closely women who have had a Cesarean section and are being administered a prostaglandin to terminate a pregnancy because of the possibility of uterine rupture.

Topics: Abortifacient Agents; Adult; Cesarean Section; Cicatrix; Dinoprostone; Female; Fetal Death; Humans; Labor, Induced; Pregnancy; Uterine Rupture

Topics: Abortifacient Agents, Nonsteroidal; Alprostadil; Delivery, Obstetric; Dinoprostone; Female; Fetal Death; Humans; Pessaries; Pregnancy; Time Factors

To evaluate the efficacy, safety and influence on subsequent fertility of sulprostone, a prostaglandin E2 analog, in terminating pathological pregnancies via the extraamniotic route.. Forty pregnant women with intrauterine fetal death or major congenital anomalies were enrolled. Sulprostone was instilled into the extraamniotic space through a silicon Foley catheter. The instillation rate was 0.5-1 microgram/min. Instillation was discontinued when the catheter was expelled or when rupture of the membranes occurred. The duration of instillation and the time interval to completion of abortion was recorded. Information about subsequent fertility was collected by telephone or at outpatient clinic visits.. The mean duration of instillation was 7.0 h and the mean dose of sulprostone was 314.8 micrograms. The mean induction-to-abortion interval (IAI) was 17.0 h. In two of the 40 patients, the cervix was not adequately ripened after 48 h and these pregnancies were ultimately terminated by alternative methods. The success rate of termination in 48 h was 92.5% (37/40). No severe side effects were encountered.. To the best of our knowledge, this is the first report in the English literature of administration of sulprostone by extraamniotic instillation for termination of pathological pregnancies. The method is effective and safe and has an insignificant influence on subsequent fertility.

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Missed; Abortion, Therapeutic; Adult; Amnion; Dinoprostone; Female; Fertility; Fetal Death; Fetus; Humans; Instillation, Drug; Pregnancy; Prospective Studies; Time Factors

A total of 85 women with antepartum fetal death between 14 and 42 weeks gestation was randomly assigned to one of two regimens of intravenous infusion of the prostaglandin analogue 16-phenoxy-17, 18, 19, 20-tetranor-PGE2-methylsulphonamide (sulprostone) for inducing labour. Women received either 1 microgram/min until delivery or the commonly recommended treatment of 1500 micrograms in 8 h followed by another, identical course of treatment if delivery did not occur within 24 h. The 1 microgram/min dose schedule used half the amount of prostaglandin and resulted in statistically significantly fewer gastrointestinal side-effects compared with the conventional treatment. All women were delivered vaginally and there were no differences in induction-to-delivery intervals between the two treatments. Sulprostone infused at a rate of 1 microgram/min resulted in a 50% chance of being delivered within 12 h and a 90% chance of being delivered within 24 h, with an overall frequency of side-effects of 20%.

Topics: Abortifacient Agents; Dinoprostone; Dose-Response Relationship, Drug; Female; Fetal Death; Gestational Age; Humans; Infusions, Intravenous; Labor, Induced; Pregnancy; Randomized Controlled Trials as Topic; Time Factors

Sulprostone was used for preoperative cervical priming in the first and second trimester in 154 patients with missed abortion, hydatidiform mole, and termination for medical indications. In 61 patients 50 mcg sulprostone was administered into the cervix ("intramural"); in 93 patients sulprostone was administered preoperatively by the intragluteal route (4 injections of 250 micrograms at 4 hour intervals). After intramural injection an abortion score of at least 20 according to Csapo (preoperative) was obtained in 78% of patients, after intragluteal administration in 98%. The intragluteal route of administration of the prostaglandin derivative sulprostone for cervical priming in the first and second trimester is much simpler than the intramural route. The injections into the cervix are painful, the desired effect is not as great, and the incidence of side effects is higher. Cervical priming in the first trimester is also recommended because it avoids the severe complications that can occur during curettage.. Sulprostone was used for preoperative cervical priming in the 1st and 2nd trimesters of pregnancy in 154 patients with missed abortion, hydatidiform mole, and termination for medical reasons. In 61 patients, 50 mcg sulprostone was administered into the cervix (intramural); in 93 patients sulprostone was administered preoperatively by the intragluteal route (4 injections of 250 mcg at 4 hour intervals). After intramural injection, an abortion score of a least 20 according to Csapo (preoperative) was obtained in 78% of the patients, after intragluteal administration in 98%. The intragluteal route of administration of the PG derivative sulprostone for cervical priming in the 1st and 2nd trimester is much simpler than the intramural route. The injections into the cervix are painful, the desired effect is not as great, and the incidence of side effects is higher. Cervical priming in the 1st trimester is also recommended because it avoids the severe complications that can occur during curettage. (author's)

Topics: Abortion, Missed; Administration, Topical; Buttocks; Cervix Uteri; Dilatation and Curettage; Dinoprostone; Female; Fetal Death; Humans; Hydatidiform Mole; Injections, Intramuscular; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Second; Prostaglandins E, Synthetic

Therapeutic interruption of the pregnancies of the 2nd and 3-rd quarter is often badly accepted by the patients and it is original that his realization is easy, effective and the less traumatic possible. In this indication, the sulprostone (Nalador) is a big contribution.. The purpose of our study is to review this product, to describe our experience concerning its use in the therapeutic interruptions of pregnancies and to study alternatives in case of failure or of against indication in its use.. It is about a forward-looking study opened from the 01-07-02 led in the service "A" of the CMNT. We brought together 30 women where a therapeutic interruption of the pregnancy was put and who did'nt present of against indications to the sulprostone.. The average age was of 27 years with extremes from 18 to 39 years 50% of our patients were nullipares. The terms of pregnancy varied from 16 to 28 LIMITED COMPANIES with an average of 20 LIMITED COMPANIES. The indications of these terminations of pregnancy were maternal in 33.33% of cases and foetal in 66.66% of cases. The average number of light bulbs of Nalador used by the women was of 2.25 with extremes going from 1 to 4. The delay of eviction from the beginning of the induction was on average of 21 hours, with a rate of success of 90%. We did not regret any break uterine Delivery was incomplete requiring a uterine revision under general anesthetic in 5 cases. Tolerance was good in general In case of failure alternatives were: the misoprostol (cytotec *), the Probe extra amniotic dries and the wet Probe.. The sulprostone by intravenous way constitutes an effective method of medical interruption of the pregnancy in the 2-nd and 3-rd quarter with a satisfactory tolerance and a rate of success of 90 %.

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Therapeutic; Adolescent; Adult; Congenital Abnormalities; Diarrhea; Dinoprostone; Female; Fetal Death; Gestational Age; Humans; Misoprostol; Parity; Pelvic Pain; Pregnancy; Prospective Studies; Time Factors; Treatment Outcome; Vomiting

Misoprostol and sulprostone are prostaglandins that can be used for the termination of second and third trimester pregnancy. The aim of the present study was to compare the effectiveness of both agents for the termination of second and third trimester pregnancy in cases of congenital or genetic abnormalities, and for the induction of labour in cases of intra-uterine foetal death.. We collected data from all women who had been treated with misoprostol in the second or third trimester of pregnancy between January 2001 and July 2002 in cases of congenital or genetic abnormalities, and for the induction of labour in cases of intra-uterine foetal death. In cases where the foetus was alive, misoprostol was usually (77%) combined with mifepristone. Women were matched to women who had been treated with sulprostone for termination of second and third trimester pregnancy before 2001. We matched for hospital, previous vaginal delivery, intra-uterine death and duration of pregnancy. The primary outcome measure was time to delivery.. Since the treatment effect was different in patients in whom labour was induced for intra-uterine death and patients in whom labour was induced while the foetus was alive, the analysis was stratified for this parameter. In 94 patients with intra-uterine death, there was no significant difference in time to delivery, blood loss, operative removal of the placenta and need for pain relief between misoprostol and sulprostone. In vital pregnancy (n = 96), time to delivery was significantly shorter in the misoprostol group. The relative risk for haemorrhage exceeding 1000 ml in this group was 0.40 (95% confidence interval, CI, 0.13-1.2). We observed no significant differences with respect to operative removal of the placenta or need for pain relief.. In cases of intra-uterine death, the effectiveness of misoprostol for termination of pregnancy is comparable to that of sulprostone. In vital pregnancy, combination of mifepristone and misoprostol is more effective than sulprostone alone.

Topics: Abortifacient Agents; Abortion, Induced; Dinoprostone; Female; Fetal Death; Fetal Diseases; Humans; Mifepristone; Misoprostol; Pregnancy; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Retrospective Studies; Treatment Outcome

Because of intrauterine foetal death at 35 weeks, parturition in a woman aged 35 years was induced by intravenous sulprostone. A few hours after its start she sustained a myocardial infarction for which she was treated. Coronary angiography 4 weeks later showed normal coronary arteries and good left ventricular function. Mild cardiovascular reactions such as bradycardia and mild hypotension are frequently observed adverse effects. In some instances, sulprostone can induce myocardial ischaemia. However, the possibility of a myocardial infarction is not mentioned in the product information of sulprostone. As there was an obvious temporal relationship and other causative factors were sufficiently excluded, the causal relation between the administration of sulprostone and the occurrence of myocardial infarction can be regarded as almost certain. Several experimental studies provide support for the hypothesis that coronary spasms play a major role in the pathophysiology of a myocardial infarction during the administration of sulprostone.

Topics: Abortifacient Agents, Nonsteroidal; Acute Disease; Adult; Coronary Angiography; Coronary Vasospasm; Dinoprostone; Electrocardiography; Female; Fetal Death; Humans; Labor, Induced; Myocardial Infarction; Pregnancy; Pregnancy Complications, Cardiovascular

This study reports the results obtained in the medical introduction of abortion during the second trimester of pregnancy in 52 patients following intrauterine fetal death or the diagnosis of fetal malformations.. The protocol consisted of the alternate use of intravaginal suppositories of gemeprost and intramuscular injections of sulprostone. The results were analysed using statistical methods and evaluated in relation to the different parameters present (intrauterine fetal death or therapeutic abortion, maternal age, gestation period and parity).. It was seen that the time required to induce abortive labour was significantly shorter in patients with IFD compared to patients with live fetus. The comparison between patients with a gestation period < or > 18 weeks revealed shorter induction times in the former group without reaching statistical significance.. Maternal age (under and over 30) and parity (P = 0 and P > or = 1) did not influence the results obtained.

Topics: Abortifacient Agents; Abortion, Therapeutic; Adult; Alprostadil; Dinoprostone; Female; Fetal Death; Fetus; Gestational Age; Humans; Injections, Intramuscular; Parity; Pregnancy; Pregnancy Trimester, Second; Suppositories

The results of the cervical priming with a Dinoprost-containing gel and a Gemeprost-containing vaginal suppository were compared in 68 patients, who required termination of pregnancy beyond 14 weeks because of a severe maternal disease or a fetal abnormality. The priming consisted of either an intracervical application of Dinoprost (500 micrograms) in a tylose-gel in 6-8 hour intervals or a retrocervical application of Gemeprost (1 mg) as a vaginal suppository in 12 hour intervals. Although no significant parameter variances were found in the selected patient groups, abortion was induced in 75% of cases within 24 hours, in 89% within 36 hours using Gemeprost. Mean induction time for Gemeprost was 19.5 hours. Using Dinoprost only 19% of patients had an abortion within 24 hours (44% within 36 hours, respectively), mean induction time was significantly longer (38.8 hours, p < 0.005). These differences remained unchanged, when patients who had a prior caesarean section were not evaluated. Using Gemeprost the additional systemic administration of Sulprost was necessary in 21% of cases, using Dinoprost, in 50% of cases. Severe complications did not occur and minor side effects such as nausea or vomiting were observed in single cases. These results demonstrate that Gemeprost can be used in cervical priming even after 14 weeks of pregnancy and that the longer application interval of 12 hours results in a reduction of side effects without a decrease in efficacy.

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Eugenic; Abortion, Induced; Alprostadil; Cervix Uteri; Dinoprostone; Drug Therapy, Combination; Female; Fetal Death; Gels; Humans; Parity; Pregnancy; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Suppositories

Termination of pregnancy was performed in a standardized, on the cervical state depending manner in 48 patients with abortion between the 16th and 27th week of gestation and in 20 women with intrauterine fetal death (IUFD) between the 28th and 41st week of gestation. At a Bishop-Score (B.S.) less than 7 cervical ripening was induced by intracervical application of 0.1 mg sulprostone gel. In patients with a very unripe cervix (B.S. less than or equal to 3) local applications of prostaglandin gel were repeated at 6 hours intervals until a B.S. greater than or equal to 5 had been achieved. For induction of labour 0.5 mg sulproston was injected intramuscularly after at least one sulproston gel application in a range between B.S. greater than or equal to 5 to 7. At a B.S. 7 intravenous infusion of oxytocin was administered, if necessary, for augmentation of labour. Most of the patients received epidural anaesthesia before induction of labour. The time interval between the beginning of the procedure and expulsion of the fetus ranged from 6.5 to 49.5 hours (mean = 26.3 h) in the abortion group and from 2.0 to 46.0 hours (mean = 20.0 h) in the IUFD group. The median interval between induction of labour and abortion/delivery was 4.3 hours (range: 0.5-27.0), and 5.5 hours (range: 0.7-9.3 h) respectively. No surgical interventions were necessary in any of the patients, and no cervical lesions occurred. Undesired systemic side effects to prostaglandins were observed in only 4 out of the 68 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Eugenic; Abortion, Induced; Cervix Uteri; Dinoprostone; Female; Fetal Death; Gels; Humans; Infant, Newborn; Labor, Induced; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Second

The authors report one case of uterine rupture in a non scarred uterus when an analogue of prostaglandin E2 was being transfused. It was Sulprostone used to terminate a pregnancy because of fetal death in utero after 27 weeks of amenorrhea. This case history and an analysis of the literature makes it possible to point out the need to reach the diagnosis before signs become too severe and to show that pharmacological knowledge of the drug has to be improved as well as the ways of administering prostaglandin analogue. This is to be conducted together with improving the ways of terminating pregnancies in the second trimester. It shows that mechanical accidents can occur even where there are no obvious risk factors. In this case, pain continued from the time of the rupture under epidural anaesthesia. The physiopathology is reviewed. Finally, conservative treatment of the uterus should be carried out whenever possible in order to allow a new pregnancy to occur and to lessen the morbidity of the operation.. The authors report a case of uterine rupture in a nonscarred uterus when an analogue of prostaglandin E2 (PGE2) was being transfused. The drug sulprostone was used to terminate a pregnancy due to fetal death in utero after 27 weeks of amenorrhea. This case history and an analysis of the literature makes it possible to point out the need to reach a diagnosis before the symptoms become too severe. It is also to show that pharmacological knowledge about the drug must be improved as well as the ways to administer the PG analogue. This should be done simultaneous to improving ways to terminate pregnancies during the 2nd trimester. It demonstrates that mechanical accidents can occur even where there are no obvious risk factors. In this case, pain continued from the time of the rupture under epidural anesthesia. In this article, physiopathology is reviewed. Finally, conservative treatment of the uterus should be conducted whenever possible in order to allow a new pregnancy to occur and reduce the likelihood of morbidity following the procedure. (author's modified)

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Therapeutic; Dinoprostone; Female; Fetal Death; Humans; Pregnancy; Pregnancy Trimester, Second; Ultrasonography; Uterine Rupture

The paper attempts to assess the efficacy of Sulprostone as a preoperative dilator of the uterine cervix in the +VIG operations performed both before and after the 90th day of amenorrhea and in cases of intrauterine fetal death. From January to September 1987, 271 cases of VIG before the 90th day of amenorrhea, 2 cases of VIG after the 90th day of amenorrhea, and 3 cases of intrauterine fetal death were operated at Vercelli Midwifery School. Sulprostone, a synthetic prostaglandin, was shown to be a valuable aid on the basis of the results obtained and the slight side effects observed.

Topics: Abortifacient Agents; Abortifacient Agents, Nonsteroidal; Abortion, Induced; Dinoprostone; Drug Evaluation; Female; Fetal Death; Humans; Pregnancy

Thirty-two patients with intrauterine fetal death after the 20th week of pregnancy were treated with 1-3 intramuscular injections of 500 mg of 16-phenoxy-PGE2-methylsulfonylamide (sulprostone). Intrauterine pressure records demonstrated onset of contractions within 20 min of injection and all women aborted-delivered after in mean 11 h (4-31 h). No effect on routine hematologic and plasma parameters, kallikrein-kinin and factor XII systems was observed. It is concluded that 16-phenoxy-PGE2-methylsulfonylamide is an effective and safe oxytocic agent for the induction of labor in case of intrauterine fetal death with minimal effects on the coagulation system.

Topics: Adult; Blood Coagulation; Dinoprostone; Female; Fetal Death; Humans; Kallikreins; Kinins; Labor, Induced; Oxytocics; Uterine Contraction

In this study, a new method for terminating second trimester pregnancies complicated by intrauterine fetal death is analysed. The technique consisted of a combination of extraamniotic ethacridine lactate with intramuscular sulprostone (16-phenoxy-omega-17,18,19,20 tetranor PGE2 methyl sulfonylamide). Objective documentation of the efficacy of this method was obtained by continuous monitoring of intrauterine pressure in two patients. The method was found to be simple, safe, cheap and effective and deserves increased acceptance.

Topics: Abortifacient Agents; Abortifacient Agents, Nonsteroidal; Abortion, Induced; Acridines; Dinoprostone; Ethacridine; Female; Fetal Death; Humans; Monitoring, Physiologic; Pilot Projects; Pregnancy; Pregnancy Trimester, Second

Labor was induced via intravenous infusion of 16-phenoxy-prostaglandin-E2-methylsulphonylamide in 13 cases of missed abortion and 19 cases of intrauterine fetal death. In all cases Bishop score was less than 4. Delivery occurred within 24 hours in all cases, with a minimal frequency of side effects (six cases of erythema above the incannulated vein and 1 case of diarrhea). The interval between the beginning of the infusion and delivery was 9.42 minutes. Uterine curettage was performed in 9 cases.

Topics: Abortion, Missed; Adult; Dinoprostone; Female; Fetal Death; Humans; Labor, Induced; Pregnancy; Prostaglandins E, Synthetic

Topics: Abortion, Induced; Abortion, Threatened; Adult; Dinoprostone; Drug Evaluation; Female; Fetal Death; Humans; Hydatidiform Mole; Pregnancy; Prostaglandins E, Synthetic

Topics: Abortion, Induced; Dinoprostone; Female; Fetal Death; Humans; Injections, Intramuscular; Labor, Induced; Pregnancy; Prostaglandins E, Synthetic

Sulproston was used to terminate 125 pregnancies from 13 to 41 weeks duration, between 1.1.1979 and 31.12.1980. The indications for termination of pregnancy included medical problems, genetic disorders and neural tube defects. Sulproston alone was used in 30 cases. In the remaining 95 cases the cervix uteri was treated with Minprostin F2a before Sulproston application. The failure rate was 20% when Sulproston alone was used at varying dosage. There were no failures using the combination therapy. Combined therapy reduced the time necessary for abortion by an average of four hours, the period of painful contractions was reduced, and less Sulproston was needed. The incidence of side effects was comparable in the two groups. There were no complications from the intracervical application of Minprostin F2a.. Sulproston was used to terminate 125 pregnancies from 13-41 weeks duration between January 1, 1979-December 31, 1980. The indications for termination of pregnancy included medical problems, genetic disorders, and neural tube defects. Sulproston alone was used in 30 cases, and the remaining 95 cases, the cervix uteri was treated with Minprostin F2alpha before Sulproston application. The failure rate was 20% when Sulproston alone was used at varying doses. There were no failures using the combination therapy. Combined therapy reduced the time necessary for abortion by an average of 4 hours, the period of painful contractions was reduced, and less Sulproston was needed. The incidence of side effects was comparable in the 2 groups. There were no complications from the intracervical application of Minprostin F2alpha. (author's)

Topics: Abortion, Induced; Adolescent; Adult; Dinoprostone; Drug Therapy, Combination; Female; Fetal Death; Humans; Pregnancy; Pregnancy Trimester, Second; Prostaglandins E, Synthetic; Prostaglandins F; Time Factors

The efficacy of intravenously administered prostaglandin E2 (PGE2) compared to that of intravenously administered 16-phenoxy-17,18,19,20 tetranor prostaglandin E2 methyl sulfonylamide (SHB 286) for termination of fetal death in utero was evaluated in 20 pregnant women from 14 to 38 weeks' gestation. Ten subjects received 1 microgram of PGE2 per minute intravenously. This rate of infusion was doubled at hourly intervals up to 8 microgram per minute. Ten subjects received 0.25 microgram of SHB 286 per minute. This rate of infusion was doubled at hourly intervals up to 2 microgram per minute. It appears that the dosage schedules of PGE2 and SHB 286 were equally effective in inducing labor. Cumulative expulsion rates and mean induction times were similar in both groups. Rates of emesis were low in both groups. Either fever greater than 38.0 degrees C, or shivering, or phlebitis at the site of infusion was observed in three patients treated with PGE2 but in no patient receiving SHB 286.

Topics: Adult; Dinoprostone; Female; Fetal Death; Humans; Injections, Intravenous; Labor, Induced; Pregnancy; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Prostaglandins E; Prostaglandins E, Synthetic; Uterine Contraction

Induction of uterine contractions was carried out with an intravenous infusion of sulprostone, a 16-phenoxy derivate of methylsulphonylamid prostaglandin E2 in 21 patients after intrauterine foetal death and in seven patients having hydatidiform mole. The mean total dose of sulprotone was estimated as 1100-1300 microgram in different groups. The mean induction-delivery time was 7-13 hours. Expellation of the foetus occurred in 20 out of 21 cases during 24 hours after commencement of sulprostone infusion. In all patients having molar pregnancy uterine contractions induced with sulprostone opened the uterine cervix for evacuation. The drug was clinically well tolerated without any serious side-effects.

Topics: Abortion, Induced; Abortion, Missed; Adult; Dinoprostone; Female; Fetal Death; Humans; Hydatidiform Mole; Pregnancy; Prostaglandins E, Synthetic; Uterine Neoplasms

The prostaglandin E2 derivative Sulprostone was used in the management of intrauterine fetal death and in therapeutic abortion in advanced pregnancy. While with extraamniotic administration there was a success rate of 50% after 24 hours, the rate of success was 86% after intramuscular administration. A cervix-ripening effect was not always observed by means of intracervical injection of Sulprostone. Such pre-treatment of the cervix did not improve the induction-abortion time after intramuscular administration of Sulprostone. Side effects were only slight following Sulprostone.. Sulprostone, a prostaglandin E2 derivative, was administered extraamniotically, intracervically, and intrmusculary in a group of 29 pregnant patients (16 to 44 years of age; 13th week to 32nd week of pregnancy) who were being treated either for therapeutic abortion or intrauterine fetal death. The success rate depended mainly on route of administration. Estraamniotic administration had a success rate of 50% after 24 hours compared with the success rate of 89% for intramuscular administration. Intracervical injection did not always result in a cervical ripening effect, although fetal expulsion occurred within 12 hours in 2 cases possibly due to a systemic action of sulprostone. Pretreatment of the cervix did not appear to affect the result substantially. Side effects were greatly reduced compared to those resulting from natural prostaglandins. This study shows that systemic administration of sulprostone is well accepted by patients and doctors alike.

Topics: Abortion, Therapeutic; Adolescent; Adult; Amnion; Cervix Uteri; Dinoprostone; Female; Fetal Death; Humans; Injections; Injections, Intramuscular; Labor, Induced; Pregnancy; Prostaglandins E, Synthetic