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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

2 cases of undiagnosed abdominal pregnancy observed in a 1-year period are reported. Both were complications of 2nd-trimester induced abortion. In case 1, a 25-year old black woman (gravida 5, para 2), multiple attempts at amniocentesis resulted only in bloody fluid. Intramuscular methyl-prostaglandin F2alpha (PGF2alpha) was administered and hypertonic saline was infused, but neither uterine cramping nor rupture of the membranes followed. PGE2 vaginal suppositories produced no change. Laparotomy revealed a large abdominal mass superimposed on the fundus, extending posterior to the uterus in the cul-de-sac. The amniotic sac contained a 15 ounce stillborn fetus. In case 2, a 33-year old black woman (gravida 2, para 1), bloody fluid was again obtained on amniocentesis. Intravaginal PGE2 suppositories and oxytocin were given, but dilation did not proceed despite uterine cramping. Examination revealed a cystic mass to the right of the uterus and fixed to the cul-de-sac. Laparotomy resulted in removal of a 45 gm macerated fetus. There appeared to be a rent in the right tube from which the gestation had been extruded with secondary implantation upon the abdominal viscera. A 3rd abdominal pregnancy observed in that time period resulted in a live birth at 41.5 weeks of gestation. Clinically, the diagnosis of abdominal pregnancy can be made by sounding the uterus. Laparoscopy will differentiate between abdominal and cornual pregnancy. Sonography is an additional diagnostic aid. When 2nd trimester abortion patients are given PGE2 as a vaginal suppository, 97% abort within 36 hours. Side effects such as vomiting, diarrhea, temperature elevation, and facial flush indicate adequate absorption. When these signs are present but expulsion of fetal tissue or membrane rupture do not occur, extrauterine gestation should be considered.
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PMID:Undiagnosed abdominal pregnancy with inadvertent prostaglandin administration. 90 Jan 63

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

Multinational midtrimester abortion trials were conducted with 2.5 mg 15-methyl-prostaglandin f2 alpha (PGF2a) given intraamniotically in 311 women, 2.5 mg 15-methyl-PGF2a compared with 40 mg PGF2a in 251 women, and 2.5 mg 15-methyl-PGF2a compared with 50 mg PGF2a in 684 women. Success rates within 48 hours were 95.2, 95.6, and 92.8% in the 3 15-methyl-PGF2a groups, 81.7% in women given 40 mg PGF2a, and 86.6% in women given 50 mg. There were 109 failures, the majority in PGF2a groups. 35 women were given supplementary treatment. Incidence of complete abortion ranged from 49 to 55% in the 5 groups, usually higher at longer gestation. Frequency of heavy bleeding was higher in PGF2a groups. Both vomiting and diarrhea occurred more frequently in the 15-methyl-PGF2a groups. Cervical rupture of up to 2 cm occurred overall in 4.4% of primigravidae and 1% of multigravidae, and 1 serious cervical rupture occurred.
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PMID:Prostaglandins and abortion. III. Comparison of single intra-amniotic injections of 15-methyl prostaglandin F2alpha and prostaglandin F2alpha for termination of second-trimester pregnancy: an international multicenter study. World Health Organization Tast Force on the Use of Prostaglandins forthe Regulation of Fertility. 92 Jul 61

The study objective was to determine the effectiveness and safety of a single high dose (40 mg) of intraamniotically administered prostaglandin F2alpha (PGF2alpha). A total of 33 women in their 14-20th week of pregnancy were selected for the study. The outcome was considered successful if the fetus and/or placenta were expelled from the uterus within 48 hours. If the fetus and placenta were expelled completely through the cervical canal the trial was recorded as complete abortion. If the placenta was retained within the uterus, completely or partially, the trial was recorded as incomplete abortion. The patients' mean age was 22.6 years. 27 patients were under 28 years of age, and 9 patients were under age 20. 25 patients were African, 2 Caucasian, and 4 Asian. 2 others were of mixed race. The mean parity of the patients was 1.4 previous pregnancies with a standard error of +or- 1.4. 17 women were nullipara; 16 women were multipara. There was 1 case of technical failure in the series, an obese Asian patient with a 16 week pregnancy in whom difficulty was experienced in entering the amniotic sac. A bloody tap during amniocentesis was obtained in 4 patients. 28 of the 32 patients aborted within 48 hours, showing a success rate of 87.5%. At the end of the first 24 hour period, 19 patients (59.4%) had aborted and an additional 9 patients (28.1%) aborted during the following 24 hours. The mean induction abortion interval was 19.4 hours. Multiparous patients aborted more frequently and in a shorter period of time than did nulliparous patients. 92.3% of the multiparous patients aborted by 30 hours; only 84.2% of the primigravida had achieved this in 36 hours. In the successful group abortion was complete in 13 patients (46.4%). In the other 15 patients (53.6%) the placenta was partially or completely retained necessitating surgical evacuation. Minor side effects were observed in 28 patients (87.5%). None of these side effects required analgesia in the form of intramuscular pethidine. Gastrointestinal disturbances were common. Vomiting occurred in 11 patients. Diarrhea occurred in 3 patients. No instances of cervical laceration or cervicovaginal fistula were observed. Bleeding was minimal in 27 patients (84.4%). In another 5 patients the amount of bleeding was moderate. In the majority of patients bleeding ceased with 2 weeks after discharge from hospital. None of the patients needed hospital readmission. No signs of vaginal or pelvic infection or delayed uterine involution were observed.
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PMID:Induction of second-trimester abortion with a single dose (40 mg) of intra-amniotic prostaglandin F2a. 92 82

To determine the practicability of administering 15(S)-15-methyl-prostaglandin F2alpha-tromethamine (15(S)-15-Me-PGF2alpha) intra-amniotically for the induction of midtrimester abortion, initially 2.5 mg. of 15(S)-15-Me-PGF2alpha was administered to 20 physically healthy gravid women, and was repeated after 24 hours in those patients who had not aborted. Within 24 hours, 65% aborted, and within 36 hours, 95% aborted. Although 67% experienced emesis, no serious complications occurred. This abortion rate is similar to that obtained with the recommended dose schedule of the dosage of prostaglandin F2alpha approved by the Food and Drug Administration and those reported with intra-amniotic administration of either hypertonic saline or urea when augmented with high, continuous, intravenous infusions of oxytocin. While the study intra-amniotic dose schedule appeared to be practicable, large, comparative studies will be necessary to determine the most satisfactory dose schedule and whether this method is more acceptable than other available methods.
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PMID:Intra-amniotic administration of 15(S)-15-methyl-prostaglandin F2alpha for the induction of midtrimester abortion. 93 8

Sixty gravidas 8 to 20 menstrual weeks' gestation were studied to evaluate (1) the efficacy of intramuscularly administered 15(S)-15-methyl prostaglandin F2alpha tromethamine (15(S)-Me-PGF2alpha) as an abortifacient; (2) the effectiveness of prochlorperazine and Lomotil for attenuation of vomiting and diarrhea; and (3) the practicability of augmenting this prostaglandin dose schedule with intracervical laminaria tents. Group I subjects received 250 mug of 15(S)-Me-PGF2alpha intramuscularly every 2 hours for the initial 24 hours and 500 mug for the next 24-hour period. Group II received the same dose schedule of prostaglandin and prearranged doses of prochlorperazine and Lomotil. Group III received the same dose schedule of prostaglandin after intracervical laminaria tents had been inserted, and prochlorperazine and Lomotil were administered by the prearranged dose schedule. It appears that (1) the 15(S)-Me-PGF2alpha was effective in inducing abortion; (2) a significant decrease in body temperature occurred; (3) the abortifacient effectiveness of this prostaglandin dose schedule was not altered by the regimen of prochlorperazine and Lomotil; (4) only diarrhea was significantly attenuated with the regimen of prochlorperazine and Lomotil; and (5) laminaria augmentation was not useful.
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PMID:Evaluation of intramuscular 15(s)-15-methyl prostaglandin F2 alpha tromethamine salt for induction of abortion, medications to attenuate side effects, and intracervical laminaria tents. 96 92

Abortion was induced in 60 patients between 8 and 18 weeks gestation using 15(S)-15 methyl PGF2alpha in one of three extra-amniotic administration schedules: 1.0 mg in viscous medium (Tylose), 1 mg in viscous medium (Hyskon) or 0.5 mg in non-viscous medium repeated at 12 hours. Eighty per cent of patients aborted within 24 hours in each group. The overall mean induction-abortion interval (+/- S.E.) was 17.6 +/- 2.0: there was no significant difference between the three groups. Twenty patients treated with 1.0 mg in viscous medium had the catheter removed immediately following the prostaglandin injection and the success rate was not significantly altered. Gastro-intestinal side effects (vomiting in 50%, diarrhoea in 32.5%) were more frequent in the patients treated with the larger dose though the difference was not statistically significant. No significant haematological or biochemical changes were detected during the 24 hours following the start of treatment in 24 patients investigated. Thirty seven of the 60 patients (61.5%) aborted completely and did not require surgical evacuation, and none lost more than 500 ml of blood, nor required transfusion. It is concluded that abortion can be induced with a single extra-amniotic injection of 1 mg of 15(S)-15 methyl PGF2alpha in viscous medium in a large percentage of patients but that the incidence of side effects is high.
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PMID:Extra-amniotic 15 (S)-15 methyl PGF2alpha to induce abortion: a study of three administration schedules. 96 56

A silastic device containing 10 mg (15S)-15-Methyl Prostaglandin F2alpha was administered vaginally in three parous patients under 50 days gestation who requested therapeutic abortion. Painful contractions appeared within one hour and vaginal bleeding within three hours of application. All patients aborted, although in one tissue had to be removed from the uterus. Plasma progesterone concentrations were measured in two patients: they decreased within four hours, then increased slightly and finally decreased 24 hours after administration of the device. Nausea, vomiting, and diarrhea were observed in all three patients. The estimated blood loss was less than 100 ml and no significant hematocrit changes were observed in all patients. In serial sonographic examinations of one patient, the fragmentation and dislodgment of the gestational sac could be observed within six hours after administration of the device. After these albeit limited experiences, it is concluded that the (15S)-15-Methyl PGF2alpha vaginal device is of great potential value for induction of early first trimester abortion.
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PMID:First experiences with a (15S)-15-methyl prostaglandin F2alpha vaginal device for termination of early first trimester pregnancy with serial sonographic observations. 96 62

A salastic vaginal device containing either 0.5% or 1.0% concentrations of 15(s)-15 methyl prostaglandin F2 alpha methyl ester was used to induce therapeutic abortion in 22 patients at 6-16 weeks gestation. The 1.0% device appeared to be an effacious and safe method with cumulative abortion rates similar to that seen with intra-amniotic and intramuscular prostaglandin administration. The 0.5% device appears less effective. Bothersome side effects of emesis and diarrhea were seen with both devices although no serious complications occurred. Uterine activity and serum levels of 15(s)-15 methyl PGF2alpha appeared to reflect the concentration of prostaglandin in the device. The use of a prostaglandin-containing silastic vaginal device appears to be a safe method of pregnancy termination which is convenient, effective, and applicable to a broad range of gestational ages.
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PMID:Clinical observations with a prostaglandin-containing silastic vaginal device for pregnancy termination. 96 68

Forty early pregnancies (menses delay 13 - 27 days) were terminated by administering four vaginal suppositoreis each containing 1.0 or 1.5 mg of 15 (S) 15-methyl-prostaglandin F2alpha-methyl ester, one every third hour. In 14 cases serial measurementsof serum estradiol and progesterone were performed during and after therapy. Uterine contractions and bleeding started 1 - 17 hours after administration of the first suppository. Abortion was complete after one week in five women (13%), and after two weeks in 30 (75%). A curettage was performed on eight women, residual placental fragments were found in seven and pregnancy continued in one woman. Mild diarrhoea (65%) and vomiting (40%) were the major side-effects, despite premedication. Estradiol and progesterone levels fell progressively during the therapy. Self-administration of 4 or 6 mg of the methyl ester caused too low a rate of complete abortion for use in practice, but it may be a valuable and practical agent for preoperative dilation of the cervix.
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PMID:Abortifacient efficiency of 15 (S) 15-methyl-prostaglandin F2alpha-methyl ester administered vaginally during early pregnancy. 97 6


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