Microcrystalline Cellulose and Crospovidone Identified in Placentas With Vaginal Misoprostol Use
| Autor: | Tyrish Page, Susan E Presnell, Daniel C Butler, Angelina Phillips, Evelyn Bruner, Ryan D. Cuff |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Placenta Pathology and Forensic Medicine Excipients 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Pregnancy medicine Humans 030216 legal & forensic medicine Abortifacient agent Cellulose Forensic Pathology Misoprostol Retrospective Studies Abortifacient Agents Nonsteroidal Obstetrics business.industry Povidone Organ Size medicine.disease Vaginal misoprostol Microcrystalline cellulose Administration Intravaginal Prostaglandin analog chemistry Female business medicine.drug |
| Zdroj: | American Journal of Forensic Medicine & Pathology. 41:176-181 |
| ISSN: | 1533-404X 0195-7910 |
| DOI: | 10.1097/paf.0000000000000557 |
| Popis: | Misoprostol is a prostaglandin analog commonly used to induce termination of pregnancy. Clandestine home terminations complicate forensic fetal autopsy when a history of misoprostol use is withheld and the gross and histologic findings are sparse, as is often the case. One hundred thirty-two placentas with no vaginal misoprostol use, low-dose misoprostol use, and high-dose misoprostol use were reviewed for the presence, volume, and locations of microcrystalline cellulose and crospovidone, common tablet fillers in misoprostol tablets. Microcrystalline cellulose and/or crospovidone was identified in 0 (0%) of 88 cases with no vaginal administration or low-dose vaginal administration and 29 (66%) of 44 placentas with high-dose vaginal administration. When identified, microcrystalline cellulose and/or crospovidone is most commonly present on the maternal surfaces of the extraplacental membranes. The presence of microcrystalline cellulose and/or crospovidone was associated with smaller placental weight (Mann-Whitney U, P = 0.019). These fillers have a reasonable sensitivity for high-dose vaginal tablet use and are very specific. Although they are not diagnostic for misoprostol administration, they provide a finding that may prompt additional investigation into the nature of the vaginal tablet administered and the circumstances surrounding birth. |
| Databáze: | OpenAIRE |
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