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)

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

The authors have studied the influence of mechanical and hormonal contraceptives on the organism of women, more specifically on their menstrual and child-bearing function. The studied women were divided into 2 groups: in the 1st group were 1532 women wearing intrauterine devices and 200 women examined in the remote period. The 2nd group consisted of 218 women using Infecundin for contraceptive purposes. The length of the observation period varied from 1 to 7 years. All women observed were healthy and of reproductive age. They were between 20 and 45 years of age. They all had a 2-phase menstrual cycle until they started to use a contraceptive. The women wearing IUD's had been using them for 6 months to 5 years. 93.4% did not show any sign of complication; 7.9% were experiencing various complications such as menstrual disorders, acute inflammations of the sexual organs; 38 women became pregnant; there was one case of spontaneous abortion; and 2 cases of extra-uterine pregnancy. 23 pregnancies went to term normally and 12 cases necessitated an induced abortion. The women from the 2nd group had been taking Infecundin for 3 months, 6 months, 12 months and over 1 year. 17 of these women were complaining of side effects such as nausea, vomiting, cardiac pain, swelling of the mammary glands, weight gain, headaches and hepatic disorders. Some histological examinations of the endometrium showed signs of endometritis. 10 women discontinued the use of Infecundin. On the whole, hormonal and mechanical contraceptives are of satisfying efficiency. They do not appear to provoke any significant complications in the menstrual and child-bearing functions of the woman. However the use of oral contraceptives tends to provoke a pronounced atrophy of the mucous membrane in the uterus. Therefore it is advisable to prescribe oral contraceptives in cycles separated by 2 to 3 month interruptions.
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PMID:[Menstrual and child-bearing functions of women using mechanical and hormonal contraceptives]. 99 12

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

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 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

The authors report about 3 cases of the congenital adreno-genital syndrome in first-born children with a high weight at birth (3900, 3600, and 4200 g) who perished in early infancy. One child, who was considered to be a boy, died of septic postoperative complications; during the operation the uterus, ovaries, tubes, phenomena of pseudofemale hemaphroditis were observed. The considerably enlarged adrenals were gyral, goffered and their cortex consisted of cells of the fetal zone. Two other boys, who perished at the age of 3 1/2 and 2 1/2 months, were sick from the birth. In the clinical picture there prevailed anorexia, dehydration, regurgitation, periodic vomiting, convulsions, clonic spasms, Hyponatrema, hyperkalemia, sudden arrest of the heart, rose no suspicion in pediatricians with respect to the salt-losing form of the adreno-genital syndrome. Post-mortem examination revealed congenital hyperplasia of the adrenals, whose cortex consisted of the fetal zone cells.
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PMID:[Congenital adrenocortical hyperplasia]. 127 80

Mifepristone (an antiprogesterone) and misoprostol (a synthetic analogue of prostaglandin E1) were administered to 60 women diagnosed with missed abortion or anembryonic pregnancy (gestation sac present but no developing embryo) equivalent to 13 weeks' gestation or less who were recruited after counselling. The median age was 227 (range 15-44), and the median duration of amenorrhoea was 71 (42-110) days. 25 of the women had been referred for ultrasound scanning because of bleeding in early pregnancy, while the rest were diagnosed by routine scanning. 29 patients had anembryonic pregnancies, and 31 had a missed abortion. Each patient received a 600 mg single oral dose of mifepristone, and 36-48 hours later misoprostol 600 mcg was given orally (400 mcg and, 2 hours later, 200 mcg). If the products of conception were not expelled within 4 hours, vaginal ultrasonography was performed. 8 patients aborted with mifepristone alone, 43 aborted after taking 600 mcg of misoprostol, and 5 more aborted after receiving a 2nd divided dose of 600 mcg misoprostol. In 3 patients the treatment failed, and they underwent evacuation of the uterus under general anaesthesia. Exploratory curettage was performed in 2 other patients at 14 and 22 days after treatment with misoprostol, but no products of conception were obtained. The median time from administration of misoprostol to abortion was 4 (1-11) hours. The median duration of bleeding after abortion was 10 (2-22) days. Side effects included nausea, vomiting (5 patients received antiemetic drugs), and diarrhoea (7 patients) from misoprostol treatment. 39 women did not want any pain relief, 13 asked for oral analgesia, and 7 obtained parenteral analgesia.
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PMID:Medical management of missed abortion and anembryonic pregnancy. 148 4

Intestinal occlusion is a rare pathologic event during pregnancy occurring mostly in the second and third trimenon when increased volume of the uterus and the consequent displacement of abdominal organs cause complications of pathologies which would otherwise escape notice, such as intestinal adhesions, to become manifest. Diagnosis is difficult for a number of reasons. Vomiting during the first trimenon and mild abdominal pain during the third are often neglected or considered to be part of the normal course of pregnancy; pain is sometimes referred to atypical sites due to the displacement of abdominal organs; in other cases, the high endorphin tonus is apt to reduce the customary defence reaction. All this should not cause time to be lost, and whenever intestinal occlusion is suspected all the necessary diagnostic procedures must at once be carried out and appropriate therapy must speedily be started so as to reduce the risk of mortality and morbidity for mother and fetus. Management of ileus in pregnancy is identical to that for the non pregnant woman, except for the need to empty the uterus in cases in which it prevents treatment or if the fetus has reached a sufficient degree of pulmonary maturity. The paper describes a case of ileal volvulus and revisits the literature analyzing the diagnostic and therapeutic options suggested.
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PMID:[Intestinal volvulus in pregnancy]. 149 64

In Ohio, a 33-year old woman who had never had an ectopic pregnancy presented at an emergency facility not physically attached to a hospital with abdominal pain over 24 hours which had become more intense during the preceding 4 hours. She did not have vaginal bleeding, diarrhea, vomiting, or pain while urinating. 2 weeks earlier she had a voluntary intrauterine abortion at 8 weeks' gestation. She had intercourse 1 week before coming to the emergency facility. She had widespread tenderness in her abdomen, especially in the lower areas. Blood cell studies suggested an infection. The attending physician presumed her to have pelvic inflammatory disease (PID) as a result of either sexual intercourse or the elective abortion. The physician called for a urinary beta human chorionic gonadotropin test to determine whether placental tissue remained in the uterus. It was positive. 60 minutes after admission, the supine patient's pain increased and her blood pressure dropped to 80/50 mm Hg from 100/60 mm Hg at admission. After administering Ringer's solution, the health team sat her up and she fainted. A repeat cell count indicated sepsis. Her blood pressure decreased to 60 by Doppler and the physician continued to give her fluids and began dopamine. After the team stabilized her, they transferred her to a hospital. Her private physician examined her and then began surgery. The physician found a tubal pregnancy and removed the affected tube and ovary. She recuperated completely. Combined intrauterine and extrauterine pregnancy occurs once in every 30,000 cases. Previous PID, use of ovulation inducing medication, and in vitro fertilization with embryo transfer increases the likelihood of this type of pregnancy occurring. Physicians should consider this possibility if a woman has any of these histories and a combination of abdominal pain, adnexal mass with pain and tenderness, peritoneal irritation, and an enlarged uterus.
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PMID:Ruptured ectopic pregnancy in a patient with a recent intrauterine abortion. 157 Sep 21

Nursing management of second trimester abortion by PGE2 suppository after cervical dilatation with laminaria or Lamicel focuses on monitoring and treating side effects, managing pain, and supporting the patient emotionally. Mean abortion time by this method is 15-17 hours, within 24 hours in 80% of women. The side effects expected from PGs are nausea, vomiting, abdominal cramps, and diarrhea. Premedication with transdermal scopolamine, and ancillary methods such as giving ice chips, airing the room, keeping the patient clean are helpful. Acetaminophen is given orally or rectally for fever, headache, or chills. A beta-adrenergic tocolytic drug such as ritodrine HC1 is given if uterine contractions become tetanic, contractions 2-3 per minute or lasting longer than 6-90 seconds, detected by palpation. This drug must be used with caution in patients with asthma. Pain management in midtrimester abortion depends solely on the woman's comfort. Meperidine, morphine, epidural anesthesia with bupivacaine, lidocaine or morphine SO4, or patient-controlled anesthesia may be used. The nurse should monitor side effects such as hypotension, allergic responses, arrhythmias, and inability to void. Midtrimester abortion is often a stress-filled experience, since women may be ambivalent upon learning of fetal abnormalities. The women should be monitored after delivery to ensure that her uterus remains contracted, and assisted if surgical removal of retained products is necessary. Patients teaching for discharge, including medication to prevent lactation, is described. A care plan is suggested for assisting the family with bereavement, based on that used in case of stillbirth or neonatal deaths.
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PMID:Second-trimester termination of pregnancy: nursing care. 156 89


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