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

The development of the antiprogestin RU-486, and its current use in France and the UK, potential other application, politics in the US, and future are presented. Ru-486, as commonly known by its company code name, rather than its generic name mifepristone, is an analogue of a progestin used in oral contraceptives, with an added chemical group that allows it to link up with the progesterone receptor, but prevents progesterone's effects. It was approved in France in 1988, and has been used for early abortion up to 7 weeks LMP on 80,000 women. French women, after an initial diagnostic appointment, take 3 200 mg tablets of RU-486, then 36-48 hr later return for a Sulprostone (prostaglandin) injection, and are checked up 4-6 weeks later. About 96% abort completely. Some have nausea, vomiting, or pain. Bleeding averages 9 days, and 1% require treatment for bleeding. 2 cardiovascular events and 1 heart attack have been associated with the prostaglandin, now contraindicated in smokers or women 35. In England, RU-486 abortions began in late 1991, for pregnancies up to 9 weeks, using a gentler prostaglandin, Gemeprost, in a vaginal suppository. Only company-trained doctors may order the drug. Research continues on lower doses of RU-486, other prostaglandins, and effects on the fetus if abortion fails. While there is no known basis for a teratogenic effect of the antiprogestin, strong uterine contractions brought on by prostaglandins, such as misoprostol, as abused for illegal abortion in Latin America, may cause birth defects. RU-486 is expected to be useful for inducing labor, dilating the cervix, emergency contraception, pre-surgical management of Cushing's syndrome, brain cancers with profesterone receptors, among other conditions. Several of the 400 or so antiprogestins known are being tested clinically, notably HRP 2000 by WHO. Political controversy is so intense in the US that Roussel, the maker of RU-486, has no intention of marketing it, and even research supplies are unreliable. Meanwhile, pro-choice groups are innovating ways to test and market antiprogestins legally, perhaps inside state lines. It is expected that a suitable prostaglandin, misoprostol, licensed for peptic ulcer, will be available soon, and even RU-486 will become generic by 1998 when its patent expires.
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PMID:Antiprogestins and the abortion controversy: a progress report. 178 9

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

Blood levels of the placental protein PP12, a protein secreted in response to progesterone, were determined in 10 women having 1st trimester abortions by RU-38486 and prostaglandin. The women were all 9 weeks pregnant, and received 600 mg RU-38486 orally at 10.30 hr, followed 48 hours later by a vaginal suppository containing 1 mg 16,16- dimethyl-trans-2-PGE1 (Gemeprost, May and Baker). They were followed by ultrasound and blood was sampled hourly after RU-38486, and 2-hourly after PG. The protein PP12, assayed by radioimmunoassay, fell significantly over 4 hours after RU-38486 (p0.05), they rose to levels higher than seen initially, and fell somewhat over the 4 hours after PG administration (n.s.). All women aborted completely 2-4 hours after PG. They experienced various side effects such as moderate vaginal bleeding (2), nausea (8), vomiting (3), cramping (10) requiring analgesia (5). This study confirms that PP12 is dependent on progesterone, shows that RU-38486 directly affects the decidua, and constitutes the 1st demonstration of an anti-progesterone effect in women.
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PMID:Circulating levels of placental protein 12 and chorionic gonadotrophin following RU 38486 and gemeprost for termination of first trimester pregnancy. 271 11

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.
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PMID:[Comparison of dinoprostone gel and gemeprost suppositories for induction of abortion in the second and third trimester]. 779 69

Gemeprost (Cervagem), a synthetic PGE1 prostaglandin analogue was used to induce labour in 20 patients with second trimester intra uterine fetal death. The mean induction abortion interval was 13.8 hours; 17 of the 20 patients delivered within 24 hours. In 17 cases the placenta was retained and the uterus was evacuated under general anaesthesia. Nausea was noted in five (25%) patients, vomiting in two (10%) and diarrhoea in three (15%). No serious side-effects were encountered.
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PMID:Gemeprost in the management of second trimester intrauterine fetal death. 819 55

Vaginal pessaries, up to a maximum of 5, each containing 1 mg of 16,16-dimethyl-trans-delta squared-prostaglandin E1, ester (Gemeprost) were inserted as high as possible into the posterior fornix of the vagina at 3 hourly intervals in 459 women with abnormal intrauterine pregnancies presenting for termination of the pregnancy. There were 145 missed abortions (31.6%), 207 intrauterine fetal deaths (45.1%), 86 molar pregnancies (18.7%), 5 anencephalics (1.1%), and 16 others (3.5%). The study was conducted from July 1981-March 1982. 402 women (87.6%) underwent abortion within the 30 hour observation period, including 139 women (30.3%) who required additional procedures to complete evacuation of the uterus. Expulsion of the uterine contents failed to occur within 30 hours in 57 women (12.4%) and alternative procedures were employed. These failures consisted of 37 missed abortions, 17 intrauterine fetal deaths, 2 molar pregnancies, and 1 pregnancy with an IUD in situ. Side effects caused by the drug were basically tolerable. 234 women (51.0%) had 1 or more side effects, gastrointestinal tract disturbances (nausea, vomiting, and diarrhea) being the most frequently observed, and moderate fever the next most frequent. There was 1 ruptured uterus.
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PMID:Evaluation of gemeprost vaginal pessaries in the termination of abnormal intra-uterine pregnancies at twelve teaching hospitals in Indonesia. 1234 11