On the mechanism of midtrimester abortions induced by prostaglandin "impact"

Prostaglandins. 1973 Jun;3(6):847-58. doi: 10.1016/0090-6980(73)90009-9.

Abstract

PIP: Using Csapo's technique, a single dose of 24.3 +or- 1.1 mg prostaglandin F2alpha (PGF2alpha) had been delivered intraamniotically to 20 sedated pregnant patients (15.9 +or- 0.6 weeks pregnant) in order to provoke a PG impact (PGI), a consequent progesterone (P) withdrawal, and a conversion of the pharmacologically refractory normal pregnant uterus into a reactive organ. The side effects were occasional and acceptable and no further PGF2alpha treatment was needed except in 4 cases (5-10 mg). Only after the Oxytocin test showed that the uterus is becoming reactive, was 50 mU/minute oxytocin infused intravenously to facilitate the evolution of IUP to 93 +or- 3 mmHg and thus promote clinical progress. All the 20 patients aborted both the fetus and the placenta in 16.5 +or- 2.1 hours, but 8 women retained small placental residues to be removed by curettage. The Csapo score was a high 92 +or- 2. As early as 3 hours after PGI, the plasma P levels already decreased significantly. They continued to decline throughout the IAT and reached a 72% withdrawal when the fetus was aborted. 15 patients whose P withdrawal was rapid, aborted before the mean IAT, while those 5 women whose P withdrawal was slow aborted after this time. Thus, the rate of P withdrawal was direct while parity and gestational age indirectly related to the IAT. Studies are in progress to elucidate further the abortifacient action of PGF2alpha and through this knowledge promote predictable therapy.

MeSH terms

  • Abortion, Induced*
  • Adolescent
  • Adult
  • Amniotic Fluid
  • Body Height
  • Body Weight
  • Curettage
  • Female
  • Fetus
  • Gestational Age
  • Humans
  • Injections
  • Muscle Contraction / drug effects
  • Nausea / chemically induced
  • Oxytocin
  • Parity
  • Pregnancy
  • Pressure
  • Progesterone / blood
  • Prostaglandins / administration & dosage
  • Prostaglandins / adverse effects
  • Prostaglandins / therapeutic use*
  • Time Factors
  • Uterus / drug effects
  • Vomiting / chemically induced

Substances

  • Prostaglandins
  • Progesterone
  • Oxytocin