Post-conceptional induction of menses with a single vaginal suppository of (15S)-15-methyl prostaglandin F2α methyl ester
| Autor: | Thomas D. Kerenyi, Jonathan Scher, Dai-Yun Jeng |
|---|---|
| Rok vydání: | 1980 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Uterus Prostaglandin Chorionic Gonadotropin Biochemistry Human chorionic gonadotropin chemistry.chemical_compound Endocrinology Pregnancy medicine Humans Vaginal bleeding Progesterone Abortifacient Gynecology Menstruation-Inducing Agents Carboprost Suppositories Abortion Induced Curettage medicine.anatomical_structure chemistry Prostaglandins F Synthetic Vagina Female medicine.symptom medicine.drug |
| Zdroj: | Prostaglandins. 20:469-479 |
| ISSN: | 0090-6980 |
| DOI: | 10.1016/0090-6980(80)90034-9 |
| Popis: | The induction of post-conceptional menses needs a technically simple method which would avoid instrumentation of the uterus. One possible method investigated in this study is the abortifacient effect of a single dose long-acting vaginal suppository containing 3.0 mg of (15S)-15-methyl prostaglandin F2 alpha methyl ester. Pregnancy was terminated successfully in 13 of the 14 subjects. Two successful patients required curettage for prolonged bleeding and retained products of conception. Prolonged vaginal bleeding and the uncertainty of endpoints with particular reference to human chorionic gonadotropin (HCG) constitute the major problem with this non-invasive method, and are discussed in the light of the data obtained.The clinical characteristics and applicability of vaginal administration of a single suppository of (15S)-15-methyl prostaglandin F2alpha (PGF2alpha) methyl ester in postconceptional induction of menses was evaluated in 14 healthy women who were no more than 7 weeks pregnant and desired pregnancy termination. Each suppository contained 3.0 mg of 15S-15-methyl PGF2alpha methyl ester in a 2.2 gm base of Witepsol E-76-A. Blood samples were collected at 0, 4, 8, and 10 hours and again at the 14th day follow-up visit for analysis of serum chorionic gonadotropin (HCG) levels using the Beta subunit radioimmunoassay as described by Vaitukaitis et.al. and serum progesterone levels using the radioimmunoassay method of Kirton et.al. Pregnancy termination was successful in all but 1 patient. Vaginal bleeding persisted for at least 14 days in 8 cases; 2 of these patients necessitated curettage at 4 weeks and 9 weeks after the procedure. The failed case was an obese woman whose pregnancy persisted. HCG levels declined below the arbitrary limit of 1 I.U./ml within 2 weeks after therapy in 36% of the cases. Plasma progesterone levels declined below the baseline level of 5 ng/ml within 2 weeks. A wide range of values was observed at 4 and 8 hours. The 1 failure case had an initial value of 72 pg/ml at 4 and 8 hours; all cases with undetectable levels at 8 hours had initial values over 138 pg/ml. In patients with prolonged bleeding, serum HCG and progesterone showed a significantly slower decline than in patients with an uneventful abortion. Diarrhea occurred in 86% of the cases and vomiting in 36%. The study illustrates the effectiveness of administration of 1 vaginal suppository containing 3.0 mg of PGF2alpha methyl ester in 1st trimester abortion. However, the bleeding and gastrointestinal side effects associated with this method preclude its widespread use. |
| Databáze: | OpenAIRE |
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