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  • Title: Abortifacient efficacy of intravaginal prostaglandin F2 .
    Author: Wentz AC, Austin K, King TM.
    Journal: Am J Obstet Gynecol; 1973 Jan 01; 115(1):27-32. PubMed ID: 4681831.
    Abstract:
    This study determines the efficacy and incidence of side effects associated with intravaginal prostaglandin F2alpha (PGF2alpha). 20 healthy patients (16 to 30 years of age; 9-16 weeks gestational age) with no history of threatened abortion in the current pregnancy were studied. Baseline hematologic, metabolic, urinary, and hormonal studies were conducted. Transabdominal amniocentesis was performed in 7 patients. The uterus was observed for spontaneous contractility. Lactose tablets with 50 mg PGF2alpha (THAM salt) were administered vaginally. The intensity and frequency of uterine contractions in the 7 monitored patients determined the treatment regimen. Prostaglandin tablets were inserted at hourly intervals to maintain frequency of contractions at 5 per 10 minute time interval and/or intensity of contractions greater than an average of 40 mm Hg over a 10 minute-period. 13 patients whose uterine activity during the abortion process was assessed by clinical observation were given a similar time schedule. Blood studies were peformed 6 hours after the onset of therapy and immediately following abortion. Analgesia were used intramuscularly as antiemetic agents where necessary. Prepared questionnaires and personal interviews were completed at the 4-week clinic visit to determine patient acceptability of the method. 19 of 20 patients aborted, with 7 classified as complete and the remaining 12 requiring a uterine exploration and curettage for removal of retained placental fragments. Average induction-complete abortion interval was 17 hours and 50 minutes. There was no difference between multiparous and primiparous patients. In 1 patient who failed to abort with the prostaglandin tablet, administration of 900 mg PGF2alpha and hypertonic saline were used to facilitate abortion which occurred 24 hours later. Emesis occurred in 18 patients, diarrhea in 13, and fever in 11. Of 15 patients who agreed to an interview during the clinic visit, 14 stated they would choose the method again. Vaginal administration of PGs appears to exert effects by systemic, rather than by local mechanism. Although this method is effective, it has a high incidence of side effects and is associated with increased utilization of professional time.
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