Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Serial im injections of 15-methyl-prostaglandin F2 alpha (PGF2a) were used to abort 515 women 10-20 weeks' pregnant in a multicenter, multinational trial. Their mean age was 25, weight 55.3 kg, parity 1.4, and gravidity 2.7. The dosage of 15-methyl-PGF2a was 200 mcg, then 300 mcg every 3 hours for up to 30 hours. 79.3% successfully aborted within 24 hours, 35% were incomplete, and 4 received additional treatment. Mean abortion times were 13.7 hours in multigravidae and 15.7 hours in primigravidae. Side effects included vomiting (2.9 episodes each), diarrhea (2.8 episodes despite routine Lomotil medication), flushing in 14.2%, and cervical laceration in 3 (.6%). It is concluded that this method would best serve to supplement another abortion method that had failed.
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PMID:Prostaglandins and abortion. I. intramuscular administration of 15-methyl prostaglandin F2alpha for induction of abortion in weeks 10 to 20 of pregnancy. World Health Organization Task Force on the Use of Prostaglandins for the Regulation of Fertility. 92 Jul 59

15-methyl-prostaglandin F2 alpha (PGF2a) was injected extraamniotically .92 mg in 5.5 ml Hyskon (dextran 70, 32%) in 660 women 10-20 weeks' pregnant for abortion. 72.6% aborted within 36 hours and 80.3% within 36 hours, but only 32.2% had complete abortions. Mean abortion intervals were 13.1 hours in multigravidae and 16.2 in primigravidae. Infrequent complaints included flushing, nausea, dyspnea, chest pain, headache, and shivering. 1 cervical laceration was reported. 6 woemn required readmission for bleeding or infection of the 53% attending for follow-up. It is concluded that this method is safe and effective for abortion.
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PMID:Prostaglandins and abortion. II. Single extra-amniotic administration of 0.92 mg. of 15-methyl prostaglandin F2alpha in Hyskon for termination of pregnancies in weeks 10 to 20 of gestation: an international multicenter study. World Health Organization Task Force on the Use of Prostaglandins for the Regulation of Fertility. 92 Jul 60

This study examines the efficacy and side effects of 15-methyl-prostaglandins F2alpha (PGF2a) free acid administered intramuscularly for midtrimester abortion. 50 healthy women aged 14 to 37 years and between 12 to 18 weeks gestation were randomly selected from the abortion clinic at the Los Angeles County/USC Medical Center, Women's Hospital to participate in the study. The prostaglandin preparation was supplied in ampules containing 1.1 mg. in 2.2 ml. of aqueous solution. The injection was given every 2 hours until the fetus was expelled or for a maximum of 12 injections. Vital signs of the patients were closely monitored. 46% (23) of the subjects aborted within 12 hours and 90% within 27 hours. Mean injection-abortion time was 13.5 hours (range, 5 3/4 to 27 hours). The effectiveness and rapidity of abortion was related with gestational age: the lower the gestational age, the shorter the abortion time. Women with more than 17 weeks gestation had a higher failure rate. Mean number of injections was 7.5. 5 patients failed to abort with prostaglandin alone, all of them primigravidas and weighing in excess of 150 lbs; supplemental therapy was provided. Side effects and complications associated with 15-methyl-PGF2a included: emesis (66%); diarrhea (76%); flushing (12%); chills (4%); fever of 100 degrees Fahrenheit (12%); pain requiring medication (16%); and blood loss (6%). The success of this method appears to be related to dosage; parity; gestational age; weight of patient; and frequency of administration. Although there were side effects, these were outweighed by rapid abortion time, mild contractions, and ease of administration. Asthma is the only medical contraindication to prostaglandin therapy.
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PMID:Midtrimester abortion with intramuscular injection of 15-methyl-prostaglandin F2alpha. 113 40

The efficacy of intravaginal administration of prostaglandin F2 alpha (PGF2alpha) in induction of abortion was determined in a clinical trial of 16 gravidas aged 21-38, parity 0-4, between the 6th-11th weeks of pregnancy. PGF2alpha tablet (50 mg) was inserted into the posterior fornix of the vagina and repeated at 1-2 hour intervals; dose range varied from 50-250 mg. Slight to severe labor-like pain was felt by all patients in the lower abdominal region 20 minutes-4 hours after PGF2alpha administration. Vaginal bleeding occurred within 30 minutes-8 hours. In all but 1 case, the fetus and the villi were expelled broken into small pieces. All 16 patients aborted, 7 completely and 9 incompletely. This form of administration is deemed efficacious as 3 patients aborted completely within 5 hours and 4 aborted completely between 15-18 hours. Bleeding in most cases occurred following the onset of abdominal pain, 30 minutes-8 hours after treatment. In another clinical trial, the efficacy of intravaginal administration of PGF2alpha in inducing menstruation was tested in 10 volunteers aged 31-40. Either 50 or 25 mg PGF2alpha tablets were used. The patients recorded their basal body temperature (BBT) every morning. Menstruation was successfully induced in 6 of 10 patients. 6 patients treated 2-3 days before the expected date of menstruation had menstrual-like bleeding 1-9 hours after PGF2alpha administration. 3 patients treated 5, 7, and 13 days (a day before BBT shift) before the expected date of menstruation did not have vaginal bleeding. 1 patient, with monophasic BBT who was treated 3 days before the expected menstruation, did not have menstrual bleeding. Amount of induced flow was more or less the same in most patients; duration of flow was normal in all cases. The mechanism of action of PG in menstruation induction is not known. The authors speculate that PGF2alpha mechanically stimulates separation of the superficial endometrium from the remainder of the uterine wall when the endometrium is in the premenstrual state. Side effects noted were nausea, diarrhea, pyrexia, slight flushing of the face, and headache.
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PMID:The induction of abortion and menstruation by the intravaginal administration of prostaglandin F 2a . 470 6

An unnatural prostaglandin (PG) (prepared by biosynthesis using the method described by Vonkerman et al.) was used to terminate midtrimester pregnancy in 3 primiparous patients aged 21-24. The PG was administered intravenously using a Palmer slow infusion pump. The patients were monitored continuously with particular attention given to pulse, respiration, blood pressure, uterine contractions and cervical dilatation. All 3 cases successfully aborted. Effective infusion rate was similar to that of PGE1 and PGE2 (5-6 mcg/minute) and side effects were trivial (minimal skin flushing, vomiting, mild urticarial reaction). 2 of the patients aborted 8 and 22 hours after infusion stopped without being conscious of continuing uterine activity; the 3rd patient necessitated infusion on the 2nd day and exhibited increased response to the infusion; however, the PG supply was exhausted and syntocinon infusion facilitated the complete abortion. This study shows that this synthetic prostaglandin containing an uneven number of carbon atoms is pharmacologically active and can induce contractions in the intact human pregnant uterus.
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PMID:The use of an "unnatural" prostaglandin in the termination of pregnancy. 555 13

The relationship between the concentrations of placental protein 14 (PP14) in uterine flushing and the endometrial morphology in the mid-luteal phase was assessed in a prospectively designed study involving the precise timing of all samples by the luteinizing hormone (LH) surge. A total of 29 regularly cycling women with unexplained infertility or recurrent miscarriage were studied. To flush the uterine cavity, 10 ml of physiological saline solution was used immediately prior to sampling of an endometrial specimen for morphological study, in the mid-luteal phase. PP14 concentrations were measured by radioimmunoassay in uterine flushings and plasma samples; the endometrium was assessed by the use of histological dating criteria and morphometric techniques. PP14 levels in uterine flushings were correlated with endometrial dating and volume fraction measurement of the glands. They were consistently below the sensitivity of the assay with histological dating of < day LH +5, or when the glandular lumen occupied < 20% of the gland. In contrast, PP14 concentrations in plasma were not related to histological dating or morphometric analyses, and did not differ in patients with normal endometrial development (20.8 ng/ml) and in those with retarded endometrial development (22.5 ng/ml). The presence of detectable concentrations of PP14 in uterine flushing was significantly associated with normal histological dating. Uterine flushing may therefore provide a reliable, non-invasive alternative to endometrial biopsy in the evaluation of endometrial function in the peri-implantation period.
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PMID:The correlation of placental protein 14 concentrations in uterine flushing and endometrial morphology in the peri-implantation period. 828 61

The concentrations of CA 125 and placental protein 14 (PP14) were measured in uterine flushings obtained throughout the luteal phase of the cycle from eight normal fertile women. The concentrations of both proteins increased in a similar pattern throughout the luteal phase of the cycle, with the most dramatic increase occurring 6 days after their luteinizing hormone surge (day LH +6). However, a greater variation in CA 125 concentrations was seen compared to that seen for PP14. The concentrations were compared to those obtained on day LH +7 of the cycle from a group (n = 35) of women with recurrent miscarriage. The ranges in concentration of PP14 and CA 125 in the flushings of fertile and recurrent miscarriage patients were very similar. However, a greater proportion of women with recurrent miscarriage (55%) had low concentrations (< 5 ng/ml) of PP14 than in the control group (12.5%) and the concentrations of PP14 in the uterine flushings were significantly less (P < 0.05) in women with recurrent miscarriage compared to the normal fertile group. There was no significant difference in the concentration of CA 125 in the uterine flushings between the two groups. Histological observation of the endometrial biopsy samples from recurrent miscarriage patients gave menstrual cycle datings that ranged from day LH +2.5 to LH +6.5 with retarded endometrium (< day LH +5) in 12 of 35 (34%) patients. Of these 12 patients, 10 (83%) had low PP14 concentrations and six (50%) had low CA 125 concentrations in their uterine flushings. In the recurrent miscarriage patients with histologically normal (> or = day LH +5) endometrial development, 10 out of 23 (43%) also had low PP14 concentrations and 8 out of 23 (35%) had low CA 125 in their uterine flushings. The results suggest that PP14 is better than CA 125 as a marker for endometrial function in this group of women. In some cases (52%) the low concentrations of PP14 in the uterine flushings could be explained by retarded endometrial development but for the others the reduction in PP14 concentration in the uterine flushing was not associated with retardation of endometrial development.
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PMID:The measurement of CA 125 and placental protein 14 in uterine flushings in women with recurrent miscarriage; relation to endometrial morphology. 856 92

In response to a question on how to avoid the rare, inadvertent intravascular or ip injection of hypertonic saline solution during therapeutic abortion, 3 consultants replied. According to Reid and Frigoletto, to avoid intravascular or ip infusion, place a small indwelling polyethylene catheter in the amniotic sac rather than a metal needle. This virtually precludes the possibility of inadvertent iv injection. When and if necessary, correct catheter placement may be confirmed by the use of fluoroscopy and amniography prior to the injection of hypertonic saline solution. The chemical imbalances associated with this accident are those encountered in severe hypernatremia with resultant brain edema and hemorrhagic softening. Bizarre paresthesia, pyrexia, altered consciousness, and, eventually, convulsions preceded the fatal cases. Peritoneal dialysis may be life saving in the event of ip injection. Naturiuretics, appropriate parenteral fluid administration, and possibly exchange transfusion might be indicated for intravascular accidents. In Goodlin's hospital there have been no cases of acute hypernatremia in the last 500 therapeutic abortions done with hypertonic saline solution. This is believed to be related to 2 changes in technique: 1) not losing the amniotic space by removing only as much amniotic fluid as can easily be obtained and 2) using a simple gravity infusion technique for the instillation of the hypertonic saline solution. During infusion it is essential that the patient be alert, for the first symptoms of intravascular injection are a slight pain, burning, or a feeling of warmth in the pelvis. If these minor symptoms are ignored and the procedure is continued, a sensation of flushing occurs throughout the body with tingling in the scalp and ringing in the ears followed finally by seizures, apnea, or coma or both. Late symptoms are those of hemolytic anemia and renal failure. From experience, serum sodium levels during these events are as high as 185 mEq/1. Along with occurrence of acute hypernatremia the contents of the amniotic cavity are sometimes extruded extraovularly through the fallopian tube into the peritoneal cavity when labor begins. Cases with serum sodium levels of 170 mEq/1 some 6-7 hours after saline instillation were observed, but by contrast these patients' only symptoms were extreme thirst and peritoneal discomfort (Lancet 1: 305, 1968). The treatment of hypernatremia is to force fluids either by mouth or iv. Since most commercial 5% dextrose in water solutions are actually 4.5% (regulations permit a 10% error), such hypotonic fluids are useful for treating hypernatremia.
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PMID:Hypernatremia from intravascular saline infusion during therapeutic abortion. 1230 84

To evaluate the efficacy and safety of PGF2a (prostaglandin) and 15(S) 15-methyl-PGF2a as abortifacient agents, the Indian Council of Medical Research studied 124 cases of medical termination of pregnancy between 10-20 weeks. 30 cases were given intraamniotic and 94 cases were given extraamniotic prostaglandin injections. All patients were constantly and carefully monitored in the postoperative ward. The age group 15-20 years had the highest % cases of intraamniotic injection while the age group 21-25 years had the highest % cases of extraamniotic injections. Highest % cases given intraamniotic injections were those with gestation period of 18-20 weeks; highest % of cases given extraamniotic route were those with gestation between 12-14 weeks. Success rate for the intraamniotic injection was 93.33% (28 aborted within 28 hours). Of the 94 given extraamniotic injection, 64 had induction-abortion interval less than 36 hours. Side effects and complications experienced included vomiting in 60% cases; diarrhea in 56.7% cases given intraamniotic injection (6% in those given extraamniotic injection); rise of temperature up to 100 degrees F after expulsion of fetus in 3.33%; cervical tear requiring suturing in 2 cases; flushing of faces after injection in 3 cases; dyspnoea following injection in 1 case; anaphylatic shock in 1, and; death in 1 (mortality rate, 0.8%) due to uncontrollable hemorrhage. It was concluded that prostaglandins are not without hazards when used for medical termination of pregnancy.
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PMID:A trial of intra-amniotic and extra-amniotic prostaglandin for medical termination of pregnancy. 1232 33

The objective of this study was to assess the LIF (leukemia inhibitory factor) concentration in uterine flushing and serum (ELISA) of women with proven fertility, infertile women and women with recurrent miscarriage. In addition, progesterone level was determined in serum. A decreased production of LIF in the uterine microenvironment was found in states of impaired fertility. With a cut-off point of 8.23 pg/ml for LIF level in uterine flushings we have achieved 86.7% sensitivity and 100% specificity in detection of women with idiopathic infertility compared to fertile controls. No correlation between LIF in serum and uterine flushing was demonstrated, rendering LIF measurements in serum useless for diagnosis of impaired infertility. We conclude that LIF measurement in uterine flushing could be a useful diagnostic tool to predict unsuccessful implantation.
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PMID:The assessment of LIF in uterine flushing--a possible new diagnostic tool in states of impaired fertility. 1468 25


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