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

Prostaglandin F2alpha was used to induce abortion or labour in 84 women between the 11th and 44th weeks of pregnancy. Three different routes of administration were used, intravenous, extra-amniotic, and intra-amniotic. The extra-amniotic infusion of prostaglandin F2alpha produced a faster response than the other two routes. Less than one-third of the dose used in the intra-amniotic group was required in the extra-amniotic group for a complete evacuation of the uterus. Vomiting and diarrhoea occurred in 40% of the women in the intra- and extra-amniotic group, while the frequency was 88% in the intravenous group. Serum levels of progesterone and oestradiol decreased in accordance with the pattern found during spontaneous deliveries. The effect of prostaglandin F2alpha on the myometrium does not appear to be mediated via changes in the blood levels of progesterone or oestradiol.
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PMID:Serum levels of oestradiol and progesterone during administration of prostaglandin F2alpha for induction of abortion and labour. 113 18

Termination of 2nd trimester pregnancy with intraamniotic administration of 15 (S) 15 methyl prostaglandin F2alpha (15 me F2alpha) was attempted in 50 patients. 1 group (25 patients) was given 1 mg of the analogue and the other group received 2.5 mg. The abortifacient efficacy of 15 me F2alpha was similar in both groups; over 90% of the patients aborted with a single dose. There was a higher incidence of vomiting, diarrhea and incomplete abortions in the group treated with 2.5 mg 15 me F2alpha. Although the mean injection-abortion interval in the 2.5 mg group was shorter, it is concluded that intraamniotic administration of 1 mg 15 me F2alpha provides a better regime, giving high efficacy with a single dose, a low incidence of side effects, and greater safety in case of inadvertent entry of the intraamniotic dose into systemic circulation.
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PMID:Termination of second trimester pregnancy with intra-amniotic 15 (S) 15 methyl prostaglandin F-2alpha - a two dose schedule study. 113 5

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

It has been reported that intra-amniotic administration of 15-methyl PGF2a (prostaglandin F2alpha) for abortion results in a high level of uterine contractility, a high rate of success, and a low incidence of side effects. This study assesses the abortifacient activity of 15-methyl PGF2alpha administered intramuscularly in 80 healthy women aged 14 to 40 with gestational ages between 8 and 22 weeks. 56 patients were nulliparious. Transabdominal intra-amniotic pressure monitoring was used to measure uterine contractility and to establish an effective dose schedule. 350 to 520 mcg of 15-methyl PGF2a were administered intramuscularly at 2-hour intervals until the onset of abortion. Intravenous oxytocin was infused in 6 cases to facilitate passage of retained placental tissue. Medications were given to reduce diarrhea, vomiting, and pain. All patients aborted. Total drug dose ranged from 900 to 8400 mcg; mean dose was 3254.32 mcg. Duration of treatment ranged from 4 to 34 hours. Induction-abortion time ranged from 5.5 to 35 hours, with mean interval of 15.70 hours. 89% of the patients experienced gastrointestinal side effects. 14 patients had temperature elevation more than or equal to 100.6 degrees F. There were no significant complications. The 15-methyl PGF2a patients were matched with 80 gravidas who had abortion using PGE2 20 mg vaginal suppositories. There were no statistical differences in interval to abortion between the 2 groups.
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PMID:Interruption of pregnancy by prostaglandin 15-methyl F2alpha. 114

Mid-trimester abortion was successfully induced in 70 of 71 patients by administration of vaginal PGE2 suppositories. The one patient who failed to abort with this method was pregnant in the blind horn of a duplex uterus. The mean abortion time for the successful inductions was 11.88 hours. Multiparous patients aborted somewhat faster than nulliparous patients, but the difference was not significant. Among the 70 successful inductions 42 patients aborted in 12 hours or less and only one patient had an abortion time of more than 24 hours. The drug appeared effective throughout the stages of gestation included in this series--from 8 to 27 weeks. Eight patients were monitored throughout the abortion procedure and uterine activity was calculated and analyzed. The development of uterine activity was gradual without the sudden rise in frequency of contractions and intrauterine baseline tonus that characterized prostaglandin administered by other methods. The most frequently encountered side effect of vaginal PGE2 suppositories was a temperature elevation, which returned to normal within a few hours of the last dose of the drug. Gastrointestinal disturbances--vomiting and diarrhea--were also common, despite a low initial dose of PGE2 and premedication with antiemetic and antidiarrheal agents. These side effects were in general well tolerated by the patients and never required termination of therapy. The cardiovascular effects of PGE2 in this series could be considered minimal. In a single patient surgical intervention was required to remove the placenta. In seven patients the placenta was removed by sponge forceps and in five patients the placenta was removed manually. There was an estimated blood loss exceeding 250 ml. in 10 patients, but transfusion was not required. Although white blood cell count rose significantly during the abortion period there were no significant changes in hematocrit or platelet count. Mid-trimester abortion with intravaginal administration of PGE2 suppositories appears to offer a valid alternative to the presently available techniques, with a rapid abortion time, high success rate, and low incidence of complications.
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PMID:Mid-trimester abortion induced by intravaginal administration of prostaglandin E2 suppositories. 115 30

The authors had performed comparative studies of the effect of the induction of abortion in late pregnancy by intraamniotic injection of 20% hypertonic NaC1 saline in 26 pregnant patients, of 25 mg prostaglandin F2alpha (PGF2alpha) at 6 hour intervals in 25 patients, a single dose of 40 mg PGF2alpha in 27 patients, and a single dose injection of 2.5 mg 15-me-PGF2alpha given to 25 patients. The highest success rate was obtained with the single dose injection of 2.5 mg 15-me-PGF2alpha and the lowest success rate was obtained with 25 mg PGF2alpha at 6 hour intervals. Despite the rather high percent of success in using the hypertonic NaCl saline, this method is more dangerous at the moment of injection and complications during the abortion (i.e., water intoxication, necrosis of tissue, coagulation defects, and others) are high. The most frequently encountered side effects when using PGs were vomiting and diarrhea. Histologic examinations of the placenta revealed massive bleedings at a frequency rate identical to PGs and hypertonic saline. The degree of isoimmunization was lower with the PGs than with hypertonic NaCl saline despite the late dates of pregnancy termination. The intraamniotic injection of the small volume solution of 15-me-PGF2alpha or PGF2alpha is simpler and easier from a technical point of view than any method recommending saline and is far more effective. (author's)
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PMID:[Intra-amniotic administration of prostaglandin F 2 alpha, 12-methyl-prostaglandin F 2 alpha and hypertonic sodium chloride solution for induction of abortion in second-trimester pregnancy]. 118 89

The practicability of an intramuscular dose schedule of 10 mug of 15(S) 15 methyl prostaglandin E2 methyl ester [15(S) Me PGE2] administered every 4 hours was evaluated in 42 subjects from 7 to 20 menstrual weeks' gestation. Half of the subjects served as controls (Group I) and half of the subjects (Group II) were treated with a medication regimen of prochlorperazine, acetylsalicylic acid, diphenoxylate hydrochloride, and atropine sulfate to evaluate the regimen's effects. Although the 15(S) Me PGE2 dose schedule appeared to be effective (74 per cent aborted in 24 hours and 95 per cent aborted within 48 hours in a mean time of 18.9 hours), Group I (control) subjects frequently had side effects: 62 per cent had emesis, 86 per cent had diarrhea, 76 per cent had shivering, and 76 per cent had fever (greater than 100 degrees F.). Fewer Group II (medicated) subjects had side effects: 43 per cent had emesis, 19 per cent had diarrhea, 52 per cent had shivering, and 43 per cent had fever. The medication regimen did not appear to interfere with the abortifacient or oxytocic effects of the 15(S) Me PGE2 dose schedule, since Group I and Group II subjects had similar cumulative abortion rates, mean abortion times, and uterine activity. Although this 15(S) Me PGE2 dose schedule is effective in first-trimester patients, it is probably less satisfactory than the conventional method of vacuum aspiration. While intramuscularly administered 15(S) Me PGE2 with medications to attenuate side effects may be practicable for inducing midtrimester abortion, especially between 12 and 16 weeks' gestation, large controlled comparative studies of the intramuscular 15(S) Me PGE2 method and other experimental and conventional methods will be necessary to determine the most satisfactory method of performing midtrimester abortions.
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PMID:The efficacy and safety of intramuscularly administered 15(S) 15 methyl prostaglandin E2 methyl ester for induction of artificial abortion. 119 Feb 75

Schulman et al reported reduction in interval-abortion time and decreased side effects when prostaglandin (PG) E2 vaginal suppositories were administered within a contraceptive diaphragm. The authors conducted a study to confirm Schulman et al' finding. 2 groups of 20 patients with gestational ages ranging from 13 to 20 weeks were matched. 1 group (non-diaphragm) had a 20 mg. suppository inserted every 4 hours high in the vaginal fornix. The other group (diaphragm) had a contraceptive diaphragm containing the suppository inserted at 4-hour intervals. The authors' protocol differed from that of Schulman's in that oxytocin sensitivity was not sought and PGE2 alone was used. Oxytocin, however, was used to promote placental expulsion following fetal delivery in 4 cases. There were no statistically significant differences observed between the groups with respect to total drug dose (84 mg. for diaphragm group and 80 mg. for non-diaphragm), abortion-interval time (15.2 hours vs. 14.3 respectively), or frequency of side effects (vomiting, diarrhea). Schulman's reduced side effects may have followed the decreased absorption rate of PGE2 and avoidance of plasma peaks secondary to reduction in drug-mucosal interface. Schulman also reported onset of uterine activity in the diaphragm group (mean, 41 minutes) versus the control group's mean of 79.4 minutes. There is no known physiologic explanation for such findings.
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PMID:Letter: PGE2 as a vaginal abortifacient - diaphragm effect. 119 86

Fifty patients between 12 and 20 weeks' gestation were treated with prostaglandin 15 (S) 15-methyl F2 alpha by repeated intramuscular injection of 250 mug at intervals of not less than 2 hours in order to evaluate its efficacy as an abortifacient. A success rate of 96 per cent was achieved with a mean initiaation-abortion interval of 16.5 +/- S.E.M. 1.12 hours. There were no serious complications. The most common side effects were vomiting in 82 per cent and diarrhea in 66 percent of cases. The abortifacient activity was correlated with serial serum progesterone determinations and continuous intra-amniotic pressure recordings in selected cases.
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PMID:Midtrimester pregnancy termination by intramuscular injection of a 15-methyl analogue of prostaglandin F2 alpha. 120 47

The investigational use of prostaglandins to establish a safe, alternative method for the termination of pregnancy has shown significant development in the United States. The introduction of second generation compounds was initiated by chemically attaching a methyl group in the 15 carbon position of prostaglandins E2 and F2alpha. These compounds prevented enzymatic degradation by the enzyme prostaglandin 15 dehydrogenase. (15S)-15 methyl prostaglandin E2 methyl ester administered by intramuscular injection has been used successfully to therapeutically terminate pregnancy in 208 women of gestational age six through 20 weeks. Side effects, not major and considered acceptable by the investigator, were vomiting, diarrhea and temperature elevations associated with shaking and chills. (15S)-15 methyl prostaglandin F2alpha (THAM), administered by intramuscular injection, has been used to terminate pregnancy in 283 women. Efficacy rates under optimal dosage regimens have reached 100% with a complete abortion rate of 96%. Gastrointestinal side effects of vomiting and diarrhea occurred, but temperature elevations with associated shaking and chills were infrequent. The mean time from initial therapy to abortion with both compounds has remained under 16 hours. A route of drug therapy for therapeutic termination of human pregnancy has been explored and developed which avoids invasion of the uterus.
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PMID:The termination of human pregnancy with prostaglandin analogs. 121 55


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