Artificial abortion at midpregnancy by mechanical stimulation of the uterus

Abortion, primarily as a measure of population control, certainly continues to be an emotional, frustrating and stressful event. In continuation of our work on stressful situations in the female life span and biochemical parameters, serum lipid peroxide levels in terms of malondialdehyde (nmol/ml) have been determined in females undergoing abortion [suction curettage (n = 30), Emcredil-induced abortion (n = 30) and spontaneous abortion (n = 40)] and were compared with appropriate gestational controls. Irrespective of the type of abortion, the serum lipid peroxide levels before abortion [mean malondialdehyde concentrations (nmol/ml): suction curettage 2.67, Emcredil-induced abortion 3.22, and spontaneous abortion 3.49] were found to be significantly elevated in comparison with those after abortion (suction curettage 1.91, Emcredil 1.97 and spontaneous abortion 1.95), indicating a maximum at peak time of stress and a minimum at the end of stress. The levels of serum lipid peroxide encountered before abortion were found to be significantly elevated in case of Emcredil-induced abortion and spontaneous abortion when compared with controls (second trimester mean levels 1.82 and first trimester 2.4) whereas the levels before suction currettage were found to be nonsignificant in comparison with controls, indicating a lesser degree of stress. It is felt that monitoring of serum lipid peroxide levels in serum and tissues (placenta), backed by scavenging enzyme superoxide dismutase, can be more helpful for corroborating safety and the risk of free radical toxicity in pregnancy and abortion.

Section: Methodsmentioning

confidence: 99%

Serum Lipoperoxides in Induced and Spontaneous Abortions

Sane

Chokshi²,

Mishra³

et al. 1991

“…The abortifacient effects of laminaria and Rivanol are both believed to stimulate the uterus mechanically [24,45,47], induce a synthesis or a release of prostaglandin from the decidua and the fetal membranes [25,38,46] and soften the cervix [25,37,48].…”

Section: Discussionmentioning

confidence: 99%

“…Induction of abortion with an extra-amniotic Nelathon catheter-condom method (Covac), sometimes with an additional oxytocin drip, is the predominant method of second-trimester pregnancy termination in Vietnam [23][24][25][26][27][28]. The drawbacks are, however, the relatively long induction-abortion intervals and the need of a curettage after expulsion of the fetus.…”

Section: Introductionmentioning

confidence: 99%

Comparative Study of Cervical Laminar Tents prior to Extra-Amniotic Injection of Ethacridine Lactate (Rivanol) and a Condom-Nelathon Catheter Method for Second-Trimester Pregnancy Interruption in Vietnam

Järnbert

Klang

Vinh

et al. 1999

Objective: To determine whether the regimen for termination of second-trimester pregnancies using laminaria tents 12–24 h prior to extra-amniotic ethacridine lactate (Rivanol) instillation, is more effective in shortening the insertion-expulsion interval than the presently used method of abortion induction by a condom/Nelathon catheter. Design: A prospective randomised comparative study was performed at Uong Bi General Hospital in Quang Ninh Province, Vietnam, on 91 women undergoing pregnancy termination in the second trimester. Interventions: The subjects were randomly allocated to 2 treatment groups, receiving either the Nelathon catheter-condom method (n = 50) or by insertion of a laminaria tent into the cervical canal for preinduction, 13–29 h before extra-amniotic instillation of ethacridine lactate (n = 34). Seven subjects were not pretreated with the laminaria tent. Main Outcome Measures: The insertion-expulsion intervals and the incidence of side effects were assessed. Results: The mean insertion-expulsion interval in the 2 groups was not significantly different (mean 27.5 ± 16.1 and 26.4 ± 16.4 h, respectively), calculating the insertion-expulsion interval from the start of active treatment, i.e. from the instillation of Rivanol or insertion of the Nelathon catheter and condom, until expulsion of the fetus. Conclusions: The laminaria-Rivanol method for pregnancy interruption is not more advantageous than the existing Nelathon catheter-condom method. Simple, successful and cost-effective methods in achieving second-trimester abortion in the Vietnamese context have therefore to be identified and tested.

“…In midtrimester patients, a 100-ml ca pacity latex balloon was inserted into the lower uterine cavity and distended with 200 ml of physiologic saline. Traction of 600 g was applied to the balloon to strengthen the efficiency of distention [6,9]. The stretch effect of this device on the uterus was controlled by ma nipulating the traction weight [6] and by increasing or decreasing the amount of the solution in the balloon.…”

Section: Lulu!-!ri!mentioning

confidence: 99%

“…According to studies of mechanical activities alone, uterine distention at any region and at any time after mid trimester regardless of fetal viability [6,7], as well as post partum [8], induces uterine activity which is initially irregular and subsequently gradually develops into coor dinated activity. However, these studies only show the summation of partial contractions and cannot provide information for evaluating the basic patterns of contrac tion or the local response of each part of the uterus.…”

Section: Introductionmentioning

confidence: 99%

Distention of the Uterus Activates Its Multiple Pacemakers and Induces Their Coordination

Manabe

Sakaguchi

Mori

1994

Self Cite

In the pregnant human uterus, pacemaker activities and their coordination processes were studied in labor induced by uterine distention. Electrical and mechanical activities of the uterus were simultaneously recorded in 6 midtrimester (normal, n = 4; fetal death, n = 2) and 8 term (normal, n = 7; fetal death, n = 1) patients. Initially, frequent and sporadical spike discharges which did not synchronize with low magnitude and irregular mechanical activities were noted. With time, synchronization of both activities developed. These findings were noted regardless of the gestational stage of the patient and fetal viability. The patterns of development and decreases in mechanical and electrical activities, together with their synchronization patterns, were positively and negatively controlled by uterine distention and its suspension, respectively. These results suggest that the uterus has multiple pacemakers in various locations, and uterine distention works as a trigger for the elevation of excitability and for coordinated and orthodromic activities.