Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The ideal anesthesia for abortion should provide rapid induction, maintenance of an adequate level of anesthesia without producing cardiorespiratory instability or increased blood loss, and the absence of complications such as anaphylactoid reactions or the side effects of nausea and vomiting. At Hungary's Semmelweis University Medical Center, pethidine-diazepam-ketamine has been the general anesthesia of choice in recent years for 1st trimester abortion. It was decided to compare this anesthesia to a new method--fentanyl-midazolam-flumazenil. Midazolam is being used increasingly in outpatient surgical procedures due to its minimal effect on the cardiovascular system. 25 consecutive 1st-abortion patients were allocated to the ketamine group and 25 were assigned to receive mindazolam. Recovery from both anesthetic preparations was evaluated by means of the Aldrete score and a visual analogue score. The most important finding was the significantly shorter recovery time after anesthesia administration in the mindazolam group (4.5 + or - 0.5 minutes) compared to the ketamine group (31.2 + or - 6.8 minutes). 92% of women in the former group but only 64% of those in the latter group voiced satisfaction with their anestheticization. Blood gas, blood pressure, heart rate, and respiration rate were within normal limits in both groups and there were no serious complications. 2 women in each group experienced slight vomiting. Also of interest was the finding that 36% of women who received the ketamine preparation complained of unpleasant dreams while under anesthesia. Given the shorter recovery time, more widespread use of fentanyl-midazolam-flumazenil is recommended in abortion.
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PMID:Fentanyl-midazolam-flumazenil anaesthesia during induced abortion. 223 23

Clinical trials in Europe have found that a single oral dose of RU-486, followed by prostaglandin administration, effectively and safely terminates early pregnancy in about 95% of women. In a multicenter study carried out in France, 1 600-mg dose of RU-486, followed 36-48 hours later by intramuscular sulprostone or intravaginal gemeprost, induced complete abortion in 96% of 2000 women with up to 49 days of amenorrhea. In a British multicenter study, the combination of RU-486 and intravaginal gemeprost induced abortion in 95% of 600 women with up to 63 days of amenorrhea. RU-486 is not effective in aborting ectopic pregnancies. Bleeding usually starts 1-2 days after treatment and lasts for 1-2 weeks. About 1% of patients have required curettage since the amount of blood loss exceeds that in a normal menstrual period. The other side effects recorded with any frequency--abdominal cramping, nausea, vomiting, diarrhea, and headache--are all transitory and mild. Only 1 case of myocardial infarction has been reported in the more than 20,000 RU-486 acceptors studied. Endometritis and salpingitis are extremely rare complications. There have been no maternal deaths, and no fetal abnormalities have been observed in women who took RU-486 alone early in pregnancy and failed to abort.
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PMID:Mifepristone (RU 486). 224 20

A 19-year old woman who developed rapid nausea, vomiting, tachypnea, and alkalosis within 90 min of taking 3.25 g quinine S04 to induce abortion, was found to have an elevated anion gap and other electrolyte abnormalities. She was normovolemic, and had benign findings on drug screen except for quinine. Her abnormal laboratory values were high serum anion gap of 20 (normal 8-14), high urine anion gap of 171, low HC03- of 29 mEq/L, high Pa)@ of 130 mm Hg, alkalotic pH of 7.5, and hypokalemia of 2.6 mEq/L. Her hypokalemia was judged due to diuresis and vomiting. She was successfully treated with intravenous fluids and supportive care and was discharged on the third day. Quinine intoxication can also cause cinchonism, which is marked by tinnitus, vertigo, blurred vision and scotomata, and possible optic atrophy or death. The toxic dose is 2 g, and the lethal dose 8 g.
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PMID:Self-induced abortion and an elevated anion gap. 249 93

The association of nausea and vomiting in pregnancy with the outcome of pregnancy was investigated in a historical cohort of 903 women in Los Angeles, California, USA. Multivariable statistical methods were employed to control for the potential confounding effects of age, ethnicity, occupation, and anti-emetic use on pregnancy outcome. The analyses indicated that vomiting was associated with decreased risk of miscarriage (adjusted odds ratio 0.18, 95% CI 0.06 to 0.53); women with nausea but no vomiting had a miscarriage risk equal to that in the sample overall. Among the subsample of women with signs of threatened miscarriage, those who had experienced vomiting had a decreased risk of miscarriage (10.3% vs 31.7% in the subsample). No statistically significant association was observed between nausea and vomiting of pregnancy and other pregnancy outcomes (perinatal mortality, fetal anomalies, neonatal anthropometric measures).
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PMID:Nausea and vomiting of early pregnancy and pregnancy outcome. An epidemiological study. 233 56

A total of 2308 mid-trimester terminations using PGE2 extra-amniotically (1608) or intra-amniotically (700) has been analysed for efficacy and immediate and early morbidity. The mean induction-to-abortion intervals were similar for the two routes. Overall, 67% of the patients were in hospital for 1 night. Morbidity rates were similar for the two administration routes and were no higher than those reported for second trimester terminations using dilatation and evacuation. Minor side-effects of vomiting occurred in 1006 (44%) and diarrhoea in 320 (14%). Forty (1.7%) lost more than 500 ml of blood during termination and 13 (0.6%) were transfused. Major complications were extremely rare and genital tract trauma only occurred in 4 (0.17%) and proven pelvic infection in 2 (0.08%) patients. Thirty-three (1.4%) were readmitted and required a surgical evacuation of the uterus. Since long-term complications have been assessed for this method of termination and found to be infrequent, we see no reason to consider a change in methods for second trimester terminations.
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PMID:2308 second trimester terminations using extra-amniotic or intra-amniotic prostaglandin E2: an analysis of efficacy and complications. 262 54

The potential for recall bias in case-control studies is a common concern. The authors assessed whether recall bias was present in exposure information reported at postpartum interview by mothers of malformed and nonmalformed infants who delivered at Brigham and Women's Hospital, Boston, during 1984. Accuracy of exposure reporting was measured by comparing interview data with exposure information documented during pregnancy in obstetric records. The authors' measure of recall bias, relative sensitivity (RS), is the ratio of exposure-reporting accuracy for mothers of malformed infants to that of mothers of nonmalformed infants. Relative sensitivity estimates that are greater than 1.0 indicate that mothers of malformed infants are more accurate reporters than mothers of nonmalformed infants. Relative sensitivity was estimated for eight exposure factors: antibiotic or antifungal drug use (RS = 1.2), urinary tract or yeast infection (RS = 2.7), history of infertility (RS = 1.4), use of birth control after conception (RS = 7.6), elective abortion history (RS = 1.1), any over-the-counter drug use (RS = 1.0), spotting or bleeding (RS = 1.2), and nausea or vomiting (RS = 0.8) These data suggest the presence of recall bias for some exposure factors. The authors advise the use of malformed controls to reduce potential recall bias in case-control studies of selected malformations and many etiologic factors.
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PMID:Reporting accuracy among mothers of malformed and nonmalformed infants. 232 34

Prostaglandin analogues have successfully been used to induce abortions in women of less than 7 weeks amenorrhea, but about 50% of these women have experienced vomiting, diarrhea, or moderate to severe pain. The antigestagen mifepristone has led to fewer side effects, but the incidence of incomplete abortion has been unacceptably high. To test the efficacy and side effects of these drugs when used in combination, 120 women of less than 56 days amenorrhea received a single 600 mg dose of mifepristone and 48 hours later 1/2 or 1 mg of the prostaglandin gemeprost administered in vaginal pessary form. Complete abortions were experienced by 119 (99%) of the women. There were no continuing pregnancies and only 1 of the women required surgical intervention. There were few gastrointestinal side effects following administration of prostaglandin, and when the smaller dose of prostaglandin was used there was a significant decrease in the incidence of severe pain. More research needs to be undertaken to determine the lowest effective doses of both drugs.
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PMID:Induction of early abortion with mifepristone (RU486) and two different doses of prostaglandin pessary (gemeprost). 265 87

Four multicentre clinical trials on interruption of early pregnancy (less than or equal to 49 days of amenorrhea) using RU 486 have been conducted in China, including 2321 subjects. The data from trials 1, 2 and 4 are presented here. RU 486 (600 mg as a single dose) was given to 299 women. A further 422 women were given RU 486 (600 mg) plus a vaginal suppository containing the Chinese domestic prostaglandin PGO5 (1 mg) 36-60 hours later. Complete abortion was achieved in 63.5% of patients receiving RU 486 alone and in 94.1% of patients receiving RU 486 plus PG (p less than 0.001). RU 486 given alone showed decreasing efficacy as the duration of amenorrhea increased. However, RU 486 combined with PG was equally effective at all time points studied (less than or equal to 35 days of amenorrhea: 98.1%, 36-42 days: 92%, 42-49 days: 87.4%). When compared with RU 486 alone Ru 486 + PG also produced a shorter bleeding time and a lower volume of blood loss (n = 21, 52 ml vs n = 13, 117 ml). Two patients from the RU 486+PG group and 4 given RU 486 alone suffered heavy bleeding, necessitating emergency curettage. No transfusions were required. The time elapsed between RU 486 intake and expulsion of the conceptus was significantly shorter in the RU 486+PG group (n = 97, 31 days) than that in the RU 486 alone group (n = 95, 4.4 4.4 days). Main side effects, nausea/vomiting and headache/dizziness, were mainly due to RU 486. PG increased the incidence of diarrhea and uterine cramp.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:RU 486 (mifepristone): clinical trials in China. 269 37

The antiprogestin RU 486 (mifepristone) has been shown to induce abortion when administered in early pregnancy, but the rate of incomplete abortion is high, around 40%. As blockage of the progesterone receptor increases the myometrial sensitivity to prostaglandins, a combination of RU 486 and a prostaglandin E2-analogue was tested for termination of pregnancy. One hundred and sixteen women, with a gestational length of less than 49 days from the first day of the last menstrual period, were treated with a daily dose of 50 or 100 mg RU 486 for 3 to 6 days, complemented with an intramuscular dose of 0.25 mg sulprostone (16-phenoxy-PGE2-sulfonylamide) on the last day of RU 486 treatment. The results confirmed that a reduction of treatment duration to 3 days is just as effective for inducing abortion (91% complete abortion) as a 4-6-day treatment regimen (95% complete abortion). Six patients had an incomplete abortion and in one the pregnancy continued unaffected. Side effects included intense uterine pain after the prostaglandin administration (16%), vomiting associated with the antiprogestin intake (9%) and after the prostaglandin administration (9%). One woman needed emergency curettage due to heavy bleeding. Six percent of the treated patients had a decrease in hemoglobin exceeding 20 g/l during the first week but no patient needed blood transfusion. No serious side effects were recorded.
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PMID:Termination of early pregnancy with RU 486 (mifepristone) in combination with a prostaglandin analogue (sulprostone). 269 44

A paracervical abscess occurred after paracervical block anesthesia was administered for induced abortion in an 18-year-old multigravida. She presented with vaginal, low abdominal and low back pain and with nausea, vomiting, chills and fever. Incision and drainage of the abscess were performed and a vaginal drain inserted under antibiotic coverage. Cultures of the abscess contents revealed multiple anaerobic organisms. Laparoscopy showed normal pelvic organs, and the peritoneal fluid cultures were negative. Postoperatively the patient became afebrile and was discharged after three days on antibiotics. To our knowledge, this case report is the first one on paracervical abscess as a complication of induced abortion with paracervical block anesthesia.
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PMID:Postabortal paracervical abscess as a complication of paracervical block anesthesia. A case report. 272 41


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