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  • Title: Electroencephalographic changes after intra-amniotic prostaglandin F2alpha and hypertonic saline.
    Author: Shearman RP, Lyneham RC, Walsh JC, Itzkowic D, Shutt DA.
    Journal: Br J Obstet Gynaecol; 1975 Apr; 82(4):314-7. PubMed ID: 1125154.
    Abstract:
    Six major convulsions have been seen among 555 patients who had therapeutic second trimester abortion by intra-amniotic prostaglandin F2alpha (PGF2alpha). Five of 21 patients receiving intra-amniotic hypertonic saline and 5 of 16 patients receiving PGF2alpha showed abnormalities in electroencephalograms after treatment. These changes were relatively minor in all saline patients and in three receiving PGF2alpha, but two patients receiving PGF2alpha showed epileptiform spike activity after infusion. There was no correlation between the electroencephalographic (EEG) changes and peripheral venous levels of PGF2alpha or its metabolite, 13, 14 dihydro-15 keto PGF2alpha (15 keto-h2-f2alpha). 37 women were tested for convulsions after termination of pregnancies with intra-amniotic prostaglandin F2alpha (PGF2alpha) at the King George Hospital and the Royal Alfred Hospital in Sydney, Australia. All patients were 16-20 weeks pregnant. None had a history of epilepsy. 5 of 21 patients receiving intra-amniotic hypertonic saline and 5 of 16 patients receiving PGF2alpha showed abnormalities in electroencephalograms (EEG) after treatment. The former group had minor phase-reversed theta transients over the temporal areas before infusion; none of these changed after induction. No spike information occurred in any of the patients in the saline group. 3 patients receiving PGF2alpha showed relatively minor changes after induction while 2 patients showed major epileptiform spike discharges at both 1 and 4 hours. It is concluded that some EEG changes are relatively common during induced 2nd trimester abortion. There appears to be no relationship between induction of EEG abnormalities and systemic levels of PGF2alpha as measured in peripheral blood. The use of intra-amniotic PGF2alpha for termination of 2nd trimester pregnancy in patients with a history of epilepsy should be avoided.
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