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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Vaginal suppositories containing 15 methyl prostaglandin F2 alpha methyl ester in a high-melt base were administered to 60 women desiring early pregnancy interruption who were no more than 56 days' (eight weeks) pregnant as calculated from the first day of the last regular menstrual period (LMP). The purpose of this study was to evaluate the safety, efficacy, and patient acceptability of this mode of noninvasive early abortion. Some factors evaluated during the study included the time interval from insertion of the suppository to the onset of cramping and bleeding. Also measured were immediate and delayed blood loss, nausea, vomiting, and diarrhea. Of the 60 patients entered into the study, 55 procedures have been judged as successful by the prospective criteria set forth in the protocol. There were no deaths or serious complications. Four patients required hospitalization and follow-up dilatation and curettage (D&C). One patient withdrew from the study after receiving a suppository and subsequently delivered a preterm infant.
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PMID:Postconception menses induction using prostaglandin vaginal suppositories. 398 46

A review of the prelegal abortion scene in the US precedes discussion of the effect of injected soap, phenol, cresol, and their compounds. The latter is based on a review of 4 toxicology books. There is little difference in the symptoms after the instillation of phenols, cresols, or soaps. Any one of those agents can cause vaginal bleeding, abdominal pain and distension, nausea, vomiting, and cramps. The damage produced by the use of Lysol thus is due to both the phenol and soap components of the compound. Following instillation into the uterus, there is coagulation necrosis of the decidua and placental site. The toxin will invariable cause thrombosis of the intrauterine and parametrial veins. The thrombosis may spread to the entire pelvic vein plexus and paravaginal, paracervical, and ovarian veins. The liver and kidney are affected by the toxin. Icterus and bile pigments in the urine and clinical evidence of liver damage are seen often. Pulmonary edema has been described as have microscopic to massive pulmonary oil emboli and thrombosis. Depression of all bone marrow elements due to toxin has been reported. The red blood cells are further depressed in number because of hemolysis. Cerebral changes include oil emboli, cerebral coagulation, necrosis, and petechial hemorrhages. Until Studdiford and Douglas described gram-negative sepsis causing shock, patients admitted with hypotension accompanying septic abortion were thought to have concealed blood loss. Studdiford and Douglas showed that gram-negative septicemia could produce hypotension. With the advent of massive antibiotic therapy for septic abortion and septic shock, most of these patients could be saved. The kidneys, after exposure to phenolic-soap comounds, show mainly lower nephron changes. As long as the toxin is in the system those changes continue until irreversible renal damage occurs. It is essential to remove the source of the poison (the affected uterus) and then remove the circulating toxins. the main problem is removal of the circulating toxin. In addition to the problems produced by fixed and circulating toxin, it has been shown that most phenol-soap induced abortions are infected. Thus it is necessary to employ the optimal antibiotic therapy for septic incomplete abortion. The initial management phase moves along classic lines. First is monitoring the vital state and supporting the systems. This includes maintaining an intravenous solution with a large-bore needle, monitoring central venous pressure, measuring urinary output, monitoring the vital signs, maintaining adequate oxygenation, and supporting the blood pressure with blood vasopressors or other agents, as needed. Second is diagnosing the extent of the illness. Third is the initial treatment, which includes reestablishment of the blood volume with blood transfusions; aggressive coverage with double or triple antibiotic therapy; correction of hypofibrinogenemia with cryoprecipitate, fresh whole blood or fresh frozen plasma, as indicated; and avoidance of overhydration in the presence of actual or suspected renal failure. After antibiotic coverage has been established, removal of retained products of conception is indicated.
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PMID:Treatment of women who have undergone chemically induced abortions. 404 35

Intravenous infusion of prostaglandins (PG) for pregnancy termination has been associated with long duration of infusion and side effects (nausea, vomiting, diarrhea, and erythema at the site of injection). Some of these side effects have been eliminated through the use of intravaginal and intrauterine administration of PGs. The authors studied the effects of intraamniotic administration of PG on the 2nd trimester pregnant uterus based on the observations that PGE2 and F2alpha are found in samples of amniotic fluid obtained during spontaneous abortion. Single intraamniotic administration of 2.5-5.0 mg PGE2 or 25 mg PGF2alpha in 10 women 13-22 weeks pregnant stimulated uterine contraction and resulted in abortion in every case. 8 women had complete abortion and 2 necessitated manual removal of the placenta. Injection-abortion interval ranged from 4-1/2-18 hours, with a mean of 11.4 hours. 4 women experienced nausea and 3 had vomiting. There were no other side effects. This route of administration appears to produce a local action on the uterus, and the procedure does not require withdrawal of any amniotic fluid.
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PMID:Second trimester abortion with single intra-amniotic injection of prostaglandins E2 or F2 alpha. 410 91

The side effects of nausea and diarrhea have frequently been observed following the administration of prostaglandin E2 or F2alpha for the induction of labor or abortion. The oral administration of prostaglandin E1 to volunteers has elicited similar reactions. Reports that aspirin might relieve some types of nausea or diarrhea led to the testing of aspirin against the diarrhea induced by the radiation therapy of cancer of the uterine cervix. The treatment of cervical cancer by a combination of external radiation and radium often produces diarrhea, probably because loops of bowel in the path of X-rays are damaged. 15 women between the ages of 47 and 65 who had been irradiated for cancer of the cervix and who had developed diarrhea that failed to respond to conventional therapy participated in a preliminary trial. When conventional therapy failed, it was abandoned and each patient was given 900 mg of soluble aspirin B.P. ("Slfrin") by mouth, 4 times daily. In 4 patients the diarrhea cleared up completely within 24 hours of taking the aspirin. The diarrhea was improved in 8 patients, although in 2 it relapsed 48 hours after improvement was 1st observed. Colicky pain which accompanied diarrhea in 3 patients disappeared during aspirin therapy. 1 patient who had severe nausea experienced marked relief. The findings indicate that aspirin may be of value in the treatment of diarrhea induced by radiation. Since prostaglandin synthesis can be provoked by many different forms of stimulation, and because aspirin at low concentrations inhibits this synthesis, it is suggested that prostaglandins are involved in radiation induced diarrhea. A carefully controlled trial of aspirin in the treatment of radiation induced diarrhea is now being conducted.
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PMID:Aspirin in radiation-induced diarrhoea. 412 59

Recent research suggests that the action of prostaglandins on the pregnant uterus is more complex than that of oxytocin. Despite the fact that prostaglandins, like oxytocin, may fall short of the ideal, preliminary work makes it apparent that prostaglandins have attributes for induction of labor that will ultimately rank them as far superior to oxytocin. A 1st sign that prostaglandins might be more than just oxytocic agents came from the discovery of the effectiveness of prostaglandin F2alpha (PGF2alpha) and prostaglandin E2 (PGE2) in inducing mid-trimester abortion. For a long time it has been known that oxytocin seldom causes abortion of a normal pregnancy. Prostaglandins cause rapid dilatation of the cervix and expulsion of the conceptus despite a lesser degree of measurable uterine activity than that induced by oxytocin. Prostaglandins do something more, either to the quality of uterine contractions or to the cervix. A major problem associated with the pharmacological use of prostaglandins has been a high incidence of unpleasant side-effects when given by routes that are associated with substantial systemic uptake. In general, doses of prostaglandins that are oxytocic result in nausea, vomiting and diarrhea when administered by the intravenous, oral or intravaginal routes. The intra-amniotic and extra-ovular routes of administration for induction of mid-trimester abortion, as described by Doctors Karim and Hillier, are examples of the successful application of the principle that prostaglandins can be effective without side-effects when they are delivered close to the site of action. Prostaglandins appear particularly well suited to induction of labor in women with prolonged fetal death, anencephaly or hydatidiform mole.
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PMID:Prostaglandins: current therapeutic status in obstetrics. 443 69

The intention of this discussion is to review recent data on prostaglandins and to speculate on their use in clinical obstetrics and gynecology. The uses of prostaglandins are the induction of term labor, therapeutic abortion, and termination of normal and abnormal pregnancies. Prostaglandins E2 and F2alpha have been used successfully to induce labor at or near term. The oral administration of prostaglandins for the induction of labor has been reported by several investigators. Elias concluded that prostaglandins are efficient and safe for the induction of labor in both intravenous and oral forms. Continuous intravenous infusion of either prostaglandins E2 or F2alpha, when administered by the intravenous route, is capable of inducing abortion. Intravenous doses of prostaglandins that will induce abortion are frequently associated with undesirable side effects such as vomiting, diarrhea, and nausea. Due to the severity of the side effects, intravenous therapy is less clinically acceptable and attention has been directed to the vaginal route of administration. The vaginal route of administration can be used to induce abortion in the 2nd trimester with either prostaglandin E2 or F2alpha. The extra-amniotic intrauterine approach has been found to be highly effective, and the rate of abortion has been about 90% within a 36-hour period. The intra-amniotic administration of prostaglandins in 2nd trimester pregnancy compares most favorably with the extra-amniotic intrauterine method and is the only method found to be acceptable in the United States.
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PMID:Prostaglandins: overview in obstetrics and gynecology. 459 9

Clinical use of PG(prostaglandin)F2alpha to perform therapeutic abortion is described. 15 patients, at gestations ranging from 8-17 weeks, were administered PGF2alpha via intravenous infusion. 6 were treated with doses increasing from 25-250 mcg/minute; the other 9 were given a constant dose of between 25 and 100 mcg/minute. Infusion time ranged from 13.5-33 hours. 6 patients aborted completely with a blood loss estimated to be under 50 cc. 3 patients aborted incompletely and required dilatation and curettage. 6 patients failed to abort and required dilatation and curettage. No major complications were reported. Troublesome side effects of nausea, vomiting, and diarrhea were frequent. These side effects were generally dose-related but capricious in terms of time of occurrence. The constant lower dose regimen was found to be superior to the graduated dose both in terms of successful outcome and in terms of side effects. The necessity for long infusion times, the 42% overall failure rate, and the high incidence of side effects led the researchers to conclude that PGF2alpha infusion is not a recommended method of therapeutic abortion; suction evacuation is preferred.
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PMID:Intravenous prostaglandin F 2 for therapeutic abortion. 463 24

Clinical research was conducted into the possible interrelationships between prostaglandin (PG) F2alpha and the human sympathetic nervous system. The study also permitted comparison of the relative sensitivity of 2 indicators of sympatho-adrenal activity: 1) the determination of circulating catecholamines, epinephrine and norepinephrine; and 2) analysis of plasma dopamine-8-hydroxylase activity. Intravenous PGF2alpha infusion was administered to college students 12-18 weeks pregnant to produce abortion; the results were compared to results from nonpregnant controls. Circulating norepinephrine but not plasma epinephrine or dopamine-8-hydroxylase levels were increased in response to the PG. There was no correlation between plasma epinephrine and plasma norepinephrine levels. Plasma dopamine-8-hydroxylase activity was found not to be significantly changed by pregnancy, administration of the analgesic and antiemetic, or the PG infusion. In fact, central venous dopamine-8-hydroxylase activity did not differ significantly from that of arterial blood. The PG did not affect cardiac output or maximal expiratory flow rate. It is suggested that the nausea and diarrhea accompanying PGF2alpha infusion may put stress on the sympathetic nervous activity causing the observed increase in plasma norepinephrine concentration. Since no changes in blood pressure, heart rate, central venous pressure, or cardiac output were observed, it is unlikely that PGF2alpha causes even slight impairment of sympathetic nervous system activity.
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PMID:Changes in human plasma catecholamines and dopamine-beta-hydroxylase produced by prostaglandin F2 alpha. 465 36

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

This paper reports on the 1st experiences with extraamniotic administration of prostaglandin F2alpha (PGF2alpha) in induced abortion. It was found that the average dose in 30 primigravidae and 32 multigravidae was approximately equal. The average time of application was 28 hours 30 minutes in the 1st group and 24 hours 40 minutes in the 2nd. In 11 cases, PG application was followed by oxytocin infusion. The method proved successful in 83.5%; partial success was achieved in 15% of the cases. As partial successes, those cases in which the cervical channel was not completely opened, the evacuation of the uterus with instruments was still achievable without difficulty. 1 failure was observed. The highest doses were needed between weeks 13-16 of pregnancy (the small numbers did not allow the computation of statistical significance). Side effects were remarkably low (e.g., nausea, vomiting, profuse perspiration). A temporary rise in temperature above 38 degrees Celsius was noted in 8 women. Compared with reports from the literature, the dose, number, and degree of side effects were lower than those found with intravenous administration. In contrast to other authors, we administered single doses up to 2000 mcg, at which time the application should be diminished. (author's)
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PMID:[Initial experiences with prostaglandin F2 in induced abortion]. 471 51


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