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

In order to simplify the operative technique and lower the postoperative complication rate, 354 healthy primigravidae were treated with a vaginal suppository containing 1 mg of 15-methyl-prostaglandin F2 alpha 12 hours prior to vacuum aspiration abortion in the first trimester. The mean cervical diameter found at the operation was 8.5 mm and in 38% of the women no further mechanical dilatation of the cervix was needed. The amount of bleeding during the operation was low (mean 30 ml, max. 300 ml). No perforations of the uterus or cervical lacerations occurred at operation. Side effects of the prostaglandin such as vomiting, diarrhea and lower abdominal pain occurred in 80% of the women and must be regarded as disturbing to the patient and seem to require that the women be hospitalized. The incidence of genital infection following the abortion was found to be 6.2%. In 8.2% of the women, the postoperative bleeding persisted for more than 14 days. It is concluded that if the frequency of side effects can be lowered by using new analogues of prostaglandins, pretreatment with vaginal suppositories may be recommended before vacuum-aspiration at legal abortion in the first trimester.
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PMID:Vaginal administration of 15-methyl-PGF2 alpha-methyl ester prior to vacuum aspiration. Peri- and postoperative complications. 667 Apr 65

A 27-year old woman admitted to the hospital after 5 days of vaginal bleeding at 12 weeks gestation had had a copper-T IUD inserted 10 months previously. The IUD string was no longer visible at pregnancy testing. Prior to admission she had experienced lower abdominal pain, increasingly heavy vaginal bleeding, fever, malaise, chills, and vomiting. Intravenous ampicillin and metronidazole were commenced and the uterus was evacuated under a general anesthetic. The copper-T was removed from the uterine cavity. A uterine swab at operation and preoperative blood cultures grew E. coli. A moderate degree of disseminated intravascular coagulation (DIC) was indicated by a coagulation profile. The case demonstrates that the copper-T may be associated with intrauterine sepsis and DIC. In the 1st trimester the risk of abortion following removal of a device is near 30%, while the rate of abortion for women in whom the string is no longer visible is near 48%. Patients presenting with pregnancy in the presence of an IUD and symptoms of sepsis should have the uterus evacuated under suitable antibiotic cover.
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PMID:Septic abortion in an IUCD user. 676 7

A case report is presented of toxic shock syndrome associated wtih diaphragm use. The patient, an 18-year old white woman, gravida 1, para 1, was in good health prior to the reported episode. She had a low transverse cesarean section for fetal distress 3 months prior to admission and had not yet resumed menstruation. 48 hours prior to admission, after unprotected intercourse, she developed a vaginal discharge requiring the use of a pad. 12 hours later she used a diaphragm, left it in place overnight, and failed to remove it the next morning. During the day pelvic and lumbar pain developed, followed by vomiting and a fever as high as 103 degrees Farenheit. That evening, 12 hours before admission, the diaphragm was removed with drainage of copious purulent discharge. The edges of the diaphragm and the discharge were blood streaked. She also developed a diffuse macular blanching rash, sparing only the circumoral region. At the time of admission the following morning her blood pressure was 60/0mmHg; pulse, 180 beats/minute; and temperature, 102 degrees Farenheit. Significant physical findings included the rash, conjunctivitis, a pharyngeal infection, and a lack of adenopathy. Pelvic examination showed a vaginal discharge, a very tender, slightly enlarged warm uterus, and normal adnexa. Cultures of the vaginal discharge were positive for Staphylococcus aureus, resistant to penicillin and ampicillin, and sensitive to methicillin, cephalothin, erythromycin, colistin, chloramphenicol, tetracycline, sulfisoxazole, and aminoglycoside antibiotics. The white blood count rose from 11,000/mm on admission to a high of 13,000/mm with a left shift the next day. The patient received 1.2 million units of intravenous penicillin every 4 hours, 80 mg of gentamicin every 8 hours, and 300 mg of clindamycin every 6 hours, as well as fluid replacement of 2 g of methylprednisolone followed by 1 g every 6 hours. The shock, fever, and rash resolved in the following 48 hours. 2 days after admission there was circumoral exfoliation. The discharge and electrolyte and renal abnormalities cleared in 3 days. Laboratory abnormalities corrected in 24-48 hours except for liver function tests. After 8 days in the hospital, the patient was discharged on 500 mg of cloxacillin every 6 hours. This particular case is unusual because it began with development of a vaginal discharge without vaginal obstruction, developed during a 24-hour period when a diaphragm was in place, and was not associated with menstruation. Whether the discharge represented staphylococcal infection is unknown, but the diaphragm certainly seems to have contributed to the course of events.
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PMID:Toxic shock syndrome associated with diaphragm use. 682 38

Changes in the external and internal cervical os after vaginal administration of a suppository containing 1 mg of 15-methyl prostaglandin F2alpha (PGF2alpha) were differentiated in this study of 19 pregnant women prior to a 1st trimester pregnancy termination. Mean age of the women was 20.6 +or- .99, mean parity was .68 +or- .2, and mean gravidity was 2.32 +or- .54. Pregnancies averaged 10 weeks duration. Cervical dilatation before administration averaged 6.89 +or- .45 mm in the external os and 3.37 +or- .43 in the internal os; compared to 10 +or- .44 mm in the external os and 8.05 +or- .57 mm in the internal os 3 hours after administration of suppositories. Mean additional dilatation prior to the procedure was 1.84 +or- .43 mm. 74% of the women experienced diarrhea, 37% had vomiting, 27% cramps, 21% nausea, 26% vaginal pain, and 26% bleeding prior to the procedure. The greater dilatation of the internal os found in the study is comparable to the behavior of the cervix in the uterus near term when lower segment changes often precede the dilatation of the external os.
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PMID:Internal and external cervical os dilation with vaginal 15-methyl prostaglandin F2 alpha. 684 41

In minor gynecological operations a narcotic is needed which is quick-acting and produces a powerful short-term effect without disturbing the contractive ability of the uterus or blood loss and without suppressing the vital functions. Trilene was tested in 400 such operations and sombrevin in 400--mainly curettage and abortions. Sombrevin breaks down rapidly in the organism; thus the patient begins to wake up in 5-8 minutes. The dose depended on the health status of the woman, her weight, and the type of operation. It was introduced at the moment of stretching of the cervical canal so that the maximum extension of the cervix would coincide with the deepest level of anesthesia. Trilene (trichloroethylene) gives a powerful analgesic effect at very small doses. The patient inhales a vapor in a concentration of 0.1-1%. No unpleasant effects are felt, and the mucous membranes are not irritated. There is no subsequent nausea or vomiting. The patients noted no feeling of pain at any time and were in continual contact with the physician during the operation. The side effects of sombrevin and trilene are given in the accompanying table.
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PMID:[Use of trilene and sombrevin anesthesia in minor gynecologic operations]. 691 48

We describe a case of fatal gas gangrene of the uterus after an apparently normal term pregnancy in a 22-year-old woman. The patient died less than 15 h after the onset of symptoms, which consisted of a single episode of vomiting and increasing hypogastric pain. Hypotension, tachycardia and renal failure were the dominant clinical features. The pathogenesis, diagnosis and treatment of uterine gas gangrene are discussed.
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PMID:Fatal Clostridium perfringens infection after normal term pregnancy. 707 37

A report is presented on 114 terminations of pregnancy during the second and third trimesters of pregnancy with a new (PGE) prostaglandin E2 derivative Sulprostone. In 84 cases, legal therapeutic abortions were induced. In 30 women an abnormal pregnancy was terminated. Sulprostone is a PG with selective activity in the uterus. It can be administered parenterally or locally. 48 women received intravenous sulprostone, 35 patients had extraamniotic injections and 31 patients had extraamniotic injections following an intramuscular injection for priming of the cervix the night before. In 103 women, the pregnancy was terminated within the first 24 hours after the administration of sulprostone (90.3%). 8 patients (7.0%) had a cervical dilatation over 2 cm. In 3 women no effect was noted. In 1 patient, the PG application was stopped because of severe vomiting. The mean administration abortion interval was 12 hours with intravenous infusion of sulprostone, 12 hours and 54 minutes following extraamniotic application and 10 hours and 30 minutes with extraamniotic administration following intramuscular priming. In 5 patients the abortion was completed after the priming administration. More than 90% of the patients required analgesia. 32.4% displayed side effects, all of mild character. The results and the methods are described and compared to other methods. (Author's modified)
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PMID:[Induction of abortion during the second and third trimester of pregnancy with sulprostone (author's transl)]. 721 68

Some form of postcoital contraception for protection against unwanted pregnancy is indispensable today especially in cases of rape, failed mechanical contraception, or 1st sexual contact without contraception. A tabletform of postcoital contraceptive would be acceptable if 100% certainty is assured and it doesn't involve adverse effects. Postcoitally administered high-dose estrogens proved effective in Macaca mulatta. Diethylstilbestrol in variable dosages with or without ethinylestradiol was used in various studies and with variable results. Pregnancy rates depended on time of coitus in cycle, contraceptive dosage, and time of administration after coitus (within 72 hours). Conjugated estrogens and various progestagens or combinations of both have been tried with variable success. Another form of postcoital contraception is IUD insertion within 7 days following unprotected coitus. Advantages of this method are the time factors and absence of adverse effects of hormonal contraceptives. Postcoital hormonal contraceptives cause changes in the endometrium which prevent blastocyst implantation. They alter tubal function affecting zygote movement towards the uterus. They have an antiovulatory effect and may be luteolytic. Estrogens have more severe side effects than progestagens. Nausea, vomiting, mastodynia, fluid retention, and vaginal bleeding can result from estrogens. Progestagens can cause irregular bleeding. Combination of both can cause menstrual irregularity. Postcoital hormonal contraceptives are contraindicated in heart and liver diseases, thrombosis, and pregnancy (teratogenic and carcinogenic effects on offspring). Pregnancy despite postcoital contraception results in extrauterine pregnancy in 10% of patients. The most important reservations in evaluating publications on this subject are: 1) lack of control group; 2) estimation of pregnancy probability is not reliable because of study population used; 3) patient fertility cannot be ascertained; and 4) reliability of information provided by patient. Conclusion from literature studies is that postcoital hormonal contraception is of value but effectiveness is not proven. More research is needed and indications are that other less radical drugs may be found in near future.
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PMID:[Postcoital contraception]. 725 97

Uterine perforation is known to be associated with IUD use. Usually the perforation occurs upon insertion, but the IUD can become embedded in the uterus and later be forced through the wall by uterine contractions. On occasion, IUDs have been noted in abdominal viscera, most often the sigmoid colon. Recently, a 20-year-old black woman was encountered whose Copper-7 IUD had perforated her appendix and had caused chronic appendicitis during pregnancy. The woman had had 3 live-born children and 1 spontaneous abortion. The Copper-7 had been inserted 6 months previously without apparent difficulty. At 21 weeks' gestation, the patient developed right lower abdominal pain radiating to the right buttock. She had no other gastrointestinal complaints, was afebrile, and exhibited no abnormal physical findings to explain her symptoms. Urine cultures were negative. 12 weeks later, the patient developed nausea, vomiting, anorexia, and constipation. She was again afebrile. After spontaneous labor at 40 weeks, the patient was delivered of a normal male infant. Following spontaneous expulsion of the placenta, the uterus was manually explored, and no IUD was found. The patient desired postpartum tubal ligation. An x-ray film of the abdomen revealed a Copper-7 IUD in the right lower quadrant at the level of the iliac crest. During the operation, it was noted that the IUD had apparently perforated the uterus 1 centimeter below the right uterotubal junction. The strings were in the myometrium, but the body of the IUD had passed transversely through the lumen of the appendix and remained embedded in it. The IUD may have induced inflammation in an otherwise normal appendix, and this seems most likely particularly because copper-containing IUDs are prone to cause irritation and adhesion formation.
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PMID:Appendiceal perforation by Copper-7 intrauterine contraceptive device. 729 85

Various drugs, including antibiotics, may be responsible for contraceptive failure and breakthrough bleeding in oral contraceptive (OC) users. A case history is reported of a woman who took OCs for 4 years without a problem. On October 16, 1978 she had a normal withdrawal bleed, and on October 20 she started the next course of Microgynon and also a 5-day course of tetracyline 500 mg 6 hourly for 3 days and also 250 mg 6 hourly for 2 days for sinusitis. She completed the course on October 24. She did not fail to take her OC, had no diarrhea or vomiting but had only a very light 2-day withdrawal bleed on November 14 and 15, 1978. She continued to take her OC for another 2 months until seen at the family planning clinic on January 8, 1979. Her uterus was then the size of at least a 12-week pregnancy. This would have corresponded with a previous menstrual period on about October 15 and indicated that she must have ovulated either when she was taking the tetracycline or in the week after. Termination confirmed the clinical assessment of the duration of pregnancy. The time course of this history of an OC user who had no problems for 4 years suggests that the tetracycline contributed to the contraceptive failure.
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PMID:Pregnancy attributable to interaction between tetracycline and oral contraceptives. 735 47


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