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

An investigation of the abortifacient activity of (15S)-15 methyl prostaglandin F2alpha methyl ester released from a vaginal polysiloxane device was performed in eleven pregnant women of 49 days gestation or less. Bleeding and contractions were induced in all women, but only seven aborted their pregnancies. Five subjects received a vaginal device impregnated with 3 mg of drug and two aborted fetal tissue. Six women were given a vaginal device containing 5 mg of drug and five aborted fetal tissue. Ten of the patients had significant side effects, nausea, emesis, diarrhea and chills. Six women expelled the device prior to the termination of therapy. This prostaglandin analogue, when administered from a vaginal polysiloxane device in early gestation was an effective abortifacient but was accompanied by systemic side effects and a high incidence of expulsion of the device prior to its scheduled removal.
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PMID:Termination of early gestation with a vaginal polysiloxane device impregnated with (15S)-15 methyl prostaglandin F2alpha methylester. 59 79

Intravaginal insertion of a 10 cm (2) silastic device with a .5% concentration of 15(s)-15-methyl-prostaglandin F2a methyl ester alone successfully induced abortion in 27 of 48 patients in the midtrimester and an additional 11 patients with a concomitant infusion of oxytocin. The mean abortion time for the 38 successful inductions was 15.35 hours. In 8 of the 10 patients who failed to abort even with concomitant oxytocin therapy, abortion was induced by serial im injections of 15-ME-PFG2a; the remaining 2 failures underwent surgical evacuation. The plasma levels of 15-ME-PGF2a methyl ester in the 11 patients studied varied widely over the first 2 hours, maintained at 4 hours, and then dropped sharply at 8 hours and declined over the abortion period in undelivered patients. Vomiting and diarrhea were the most common side effects and in general well tolerated by the patients. However, there was an adverse reaction in a single patient who experienced almost constant nausea, vomiting, and diarrhea. The device was removed 1 hour and 50 minutes after insertion and the patient aborted spontaneously 7 hours later. Intravaginal insertion of a sliastic device is an effective means of prostaglandin abortion, but further investigation is required to determine the most effective device which would provide a slow, continuous release of the prostaglandin.
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PMID:The effect of a 10 cm2, 0.5% 15-ME-PGF2alpha methyl ester intravaginal silastic device on abortion and plasma prostaglandin concentration. 85 75

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

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

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

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

A study involving 115 women was conducted to determine the effectiveness of doses of PGR2alpha (prostaglandin F2alpha) and urea for 2nd trimester abortions. 2.5-20 mg of PGF2alpha was combined with 80 gm of urea to induced abortion, with 10 mg being the optimal dose. Only 2 patients had not aborted after 36 hours and only 6 patients required a 2nd injection at 24 hours; laminaria tents did not shorten abortal times. For 33 multiparous patients the mean abortal time was 14.3 hours and for 82 nulliparous women, the mean abortal time was 16.4 hours. 30% of the women had the placenta removed operatively using intravenous sedation. Vomiting occurred in 19 women, nausea in 4 women, 8 became febrile, 2 received blood transfusions for hemorrhage, and 2 had a 4-cm cervical laceration
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PMID:Intra-amniotic prostaglandin F2alpha and urea for midtrimester abortion. 100 22

In order to evaluate the efficacy and acceptability of 15(S)-15-methyl-prostaglandin F2alpha (15-me-PGF2alpha) for pregnancy termination, we induced 30 abortions with single intra-amniotic injections of 2,5 mg of 15-me-PGF2alpha and 25 abortions with intra-muscular 15-me-PGF2alpha administered 200 mug initially and 300 mug every third hour until 30 hrs or abortion. Abortion occurred within 30 hrs in 97% of cases in the intra-amniotic group, with a mean abortion time of 17,6 hrs and in 80% in the intramuscular group, with a mean abortion time of 15.0 hrs. Neither parity nor gestational age was significantly related to the abortifacient efficacy of 15-me-PGF2alpha. No serious complications occurred. Vomiting (83-84%) and diarrhoea (23-92%) were the most common complaints. Uterine contractions were more painful if induction was effected with intra-amniotic rather than intramuscular injections. 15-me-PGF2alpha appears to be an effective and practicable abortifacient which can be used intra-amniotically or intramuscularly according to the ease of amniocentesis.
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PMID:Induction of abortion with intra-amniotic or intra-muscular 15(S)-15-methyl-prostaglandin F2alpha. 110 93


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