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

This study determines whether induction of second trimester abortions with intraamniotic prostaglandin F2alpha (PgF2a) could be facilitated by use of intravenous oxytocin, and whether side effects of prostaglandin administration could be minimized by using lower doses of prostaglandin in conjunction with oxytocin. 26 healthy pregnant females aged 16 to 39 years (16 to 26 weeks gestation) were divided into 2 groups: group 1 consisting of 12 patients who had intraamniotic injection of PGF2a 25 mg. followed by additional doses of 5 to 25 mg. injected at intervals of 8 to 10 hours (mean dose, 40.2 mg.), and group 2, consisting of 14 patients who had intravenous infusion of oxytocin 2 hours after intraamniotic injection of 25 mg. PGF2a (mean dose, 28.2 hours). 9 out of 12 patients in group 1 aborted within 36 hours (mean abortion time, 24 hours and 41 minutes) while all patients in group 2 aborted within 28 hours (mean abortion time, 15 hours and 37 minutes). Nausea, vomiting, and diarrhea occured in 9 group 1 patients while 2 patients in group vomited. There were no significant changes in blood pressure, heart rate, respiration or metabolic parameters. This study shows that under carefully controlled conditions, administration of intravenous infusion of oxytocin following intraamniotic administration of PgF2a shortens injection to abortion time.
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PMID:Mid-trimester abortion with intra-amniotic prostaglandin F2 alpha and intravenous oxytocin infusion. 113 39

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

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

The introduction of dinoprost tromethamine (Prostin F2 Alpha) as an abortifacient in the second trimester of pregnancy represents the first clinical use of a prostaglandin. Various synthetic analogues of the naturally occurring derivatives are being employed investigationally in the treatment of peptic ulcer, hypertension, asthma, and hypercalcemia. In the United States, dinoprost tromethamine is primarily administered intra-amniotically. Despite the fact that a substantial number of patients experience allergic reactions, hypertension, bronchospasm, nausea, vomiting, cramps, and diarrhea, the efficacy and relative safety of dinoprost tromethamine establish it as superior to intra-amniotic instillation of hypertonic saline. Cervical laceration, laceration or rupture of the lower uterine segment, retention of the placenta, and hemorrhage in part reflect the intensity of uterine contraction induced by dinoprost. Experience in administration improves the therapeutic response and diminishes adverse reactions.
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PMID:The prostaglandins. 117 7

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 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

Midtrimester abortion was successfully induced in 117 of 120 patients with serial intramuscular injections of 15(S)-15-methyl-prostaglandin F2alpha (15-me-PGF2alpha). The mean abortion time was 14.12 hours, and parous patients aborted in a mean of 12.85 hours-significantly faster than nulliparous patients who aborted in a mean of 15.24 hours. Ninety-four per cent of the 117 successfully induced abortions occurred in less than 24 hours and 46 per cent in less than 12 hours. Uterine activity was monitored and analyzed in nine patients. Uterine response to a single intramuscular injection of 100 mug of 15-me-PGF2alpha was characterized by the appearance of low-amplitude, high frequency contractions and a rapid increase in baseline intrauterine tonus. A high level of uterine activity, 900 Montevideo Units, was observed within 30 minutes of the first intramuscular injection of 15-me-PGF2alpha. This activity was not maintained and decreased by approximately 30 per cent at the time of the second injection at 1 hour. It was not until 6 hours of 15-me-PGF2alpha therapy that activity stabilized at approximately 500 Montevideo Units. Even though all patients were premedicated with antiemetic and antidiarrhea agents, 68 of 120 patients experienced gastrointestinal side effects related to the 15-me-PGF2alpha administration. Vomiting was the most prevalent side effect, occuring in 65 patients, but the episodes were not severe, were well tolerated by the patients and did not necessitate the termination of prostaglandin administration in any of the patients. In this study abortion was successfully induced between weeks 9 to 27 of gestation. It was observed that patients with gestations of 16 weeks or less aborted significantly faster than patients with gestations of 17 weeks or more, which indicates that this method is highly effective in the induction of abortion within the "gray zone", 12 to 16 weeks of gestation.
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PMID:Termination of midtrimester pregnancy by serial intramuscular injections of 15(S)-15-methyl-prostaglandin F2alpha. 124 53

In 1989-90 in India, physicians used 4 different methods to induce second trimester abortion (14-20 weeks gestation) in 200 women at the Lokmanya Tilak Municipal General Hospital in Sion in Bombay. In 50 women each, they introduced 200 ml of 20% hypertonic saline into the amniotic sac, after removing 35-200 ml of amniotic fluid; 150 ml of ethacridine lactate extraovularly; prostaglandin F2 intramuscularly at regular intervals; and a cupful of 5% povidone-iodine topical solution in 150 ml of sterile normal saline extraamniotically. Intravenous oxytocin drip was started the morning after induction in all but those women receiving prostaglandin F2 to reduce the induction-abortion interval. 5% povidone-iodine solution successfully induced abortion in 100% of cases. The success rates for ethacridine lactate, hypertonic solution, and prostaglandin F2 were 98, 96 and 90%, respectively. Ethacridine lactate had the highest complete abortion rate (42%) followed closely by 5% povidone-iodine (39%). Prostaglandin F2 resulted in the shortest mean induction-abortion interval (20 hours vs. 38 hours for hypertonic solution, 30 hours for ethacridine lactate, and 32 hours for 5% povidone-iodine solution. 4 (8%) of the 50 women who underwent an abortion induced by hypertonic solution required a blood transfusion. Another woman undergoing hypertonic solution abortion developed disseminated intravascular coagulation and died. The only women who experienced vomiting and loose stools were women receiving prostaglandin F2 (30 women [60%]). The most cost-effective abortion method was 5% povidone-iodine solution in normal saline, indicating that this is the preferred method for poor patients.
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PMID:Comparative study of midtrimester termination of pregnancy using hypertonic saline, ethacridine lactate, prostaglandin analogue and iodine-saline. 146 Mar 14

The dosage of Prostaglandin F2 alpha used until the present (100, 250 and 1000 micrograms/kg bw), in order to treat pyometra in the bitch, was accompanied with side effects such as salivation, vomiting and diarrhea. In the present work, the efficiency of low dose Prostaglandin (20 micrograms/kg bw) was examined in two different groups of patients: Group 1: Included 9 bitches pregnant for a period of 5-7 weeks duration. Initially the bitches were treated 3 or 4 times per day with Prostaglandin F2 alpha. In these cases abortion took place within 4 to 11 days. Group 2: 12 dogs, suffering from pyometra, were treated 3 times per day with PGF2 alpha for 8 days. In 9 dogs the pyometra resolved and the bitches came in estrus 2-5 months after treatment. 7 bitches have been mated and 6 of these gave birth to healthy litters. During a follow-up period of at least 10 months there has not been a reoccurrence of pyometra. In 3 out of the 12 dogs the uteri were still enlarged after 8 days of treatment. These bitches underwent ovariohysterectomy and a cystic hyperplasia of the endometrium was diagnosed histologically. The low dose (20 micrograms/kg BW) Prostaglandin F2 alpha induced in all dogs the expulsion of the uterine contents. Side effects during the treatment were not observed.
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PMID:[Use of a low dose prostaglandin F2 alpha in bitches]. 196 76


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