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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Researchers analyzed data on 80 pregnant women seeking a 2nd trimester abortion due to fetal abnormalities at the Federico II Medical School at the University of Naples in Italy to determine the effectiveness and side effects of 2 different prostaglandin analogues and their ability to bring about cervical ripening and uterine contractions. 40 women received 1 mg Gemeprost every 3 hours up to 5 mg in vaginal suppository form while the other 40 women who tended to be primigravidae received an intramuscular injection of 500 mcg Sulprostone every 4 hours up to 2000 mcg. Sulprostone achieved an 85% success rate and Gemeprost achieved an 82.5% success rate. Complete abortion occurred more quickly for multigravidae patients than it did for primigravidae patients (in hours, 10.6 vs. 16.5 for Gemeprost, p.1; 9.83 vs. 15.65 for Sulprostone, p.01). There was no statistically significant difference between the 2 treatment groups, however. Side effects were more common among Sulprostone patients than among Gemeprost patients (40% vs. 22.5%). The most common side effects among Sulprostone patients were, in descending order, abdominal pain (75%), diarrhea (50%), and nausea (50%). For Gemeprost patients, they were abdominal pain (55.5%) and headache (44.4%). In terms of uterine contractility, Sulprostone brought about hypertone more quickly than did Gemeprost (in minutes, 18.32 vs. 36.75; range 10-30 vs. 25-50). Gemeprost treatment was more like physiological labor than was Sulprostone treatment. Both prostaglandin analogues produced similar histological and ultrastructural findings of cervical ripening. These results indicated that the women were better able to tolerate Gemeprost.
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PMID:Uterine motility and cervical ripening in second trimester elective abortion by two different PGE analogues. 179 Jun 8

The synthetic prostaglandin E2 derivative Sulprostone (16-phenoxy-W-17, 18, 19, 20-tetranor) is an effective 2nd trimester abortifacient. This study compares 2 dosage regimens of intramuscular administration. In regimen 1, 9 women with intact pregnancy and 3 with intrauterine fetal death were given Sulprostone 500 mcg 3 times at 4-hour intervals to be repeated after 24 hours if abortion did not occur. In regimen 2, 12 women with intact pregnancies were given Sulprostone 500 ug every 6 hours for up to 6 injections or 3000 mcg. Either regimen was considered a failure if expulsion did not occur within 48 hours. 15 of 21 cases of intact pregnancy were successfully aborted, yielding a total success rate of 71.4%. Regimen 1 was 66.7% successful, with a total dosage of 2250 mcg, and regimen 2 was 75% successful, with a total dosage of 2055 mcg. In regimen 1 the total dose was lower for primigravidas than for multiparas; in regimen 2 it was lower for multiparas. All 3 cases of intrauterine death were aborted after a single course of dosage regimen 1. 2 failures aborted spontaneously after 49 and 80 hours, and 4 were aborted by intraamniotic saline solution. In both regimens side effects (vomiting and diarrhea, chills and fever, dizziness, headache, and dyspnea) were minimal. The 1st regimen is recommended because, if injections are started early in the day, it can be used to induce midtrimester abortion on an outpatient basis.
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PMID:Clinical trials of intramuscular sulprostone for second trimester abortion. 304 4