Cardiac Standstill Induced by Prostaglandin Pessaries

Kalra, Philip A.; Litherland, D.; Sallomi, D. F.; Critchley, Hilary; Falconer, Gladys; Holmes, A.M.

doi:10.1016/s0140-6736(89)90177-3

Cited by 19 publications

(6 citation statements)

References 8 publications

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“…Our findings thus raise strong doubts about the relevance of animal toxicity tests of misoprostol in the human. The cost of alternative approaches, particularly that of mifepristone and gemeprost [17] as well as claimed seri ous side effects of prostaglandin-only preparations [18,19] make the use of vaginal misoprostol an interesting alternative. In the current study an unconventional appli cation of tablets marketed for peroral use resulted in preg nancy termination using misoprostol in a dose of 800-1,600 pg.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy Interruption by Vaginal Misoprostol

Bugalho

Bique

Almeida

et al. 1993

Gynecol Obstet Invest

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A total of 132 pregnant women with average gestational age of 14.2 weeks (range 11–22 weeks) undergoing legal abortion volunteered for a trial utilizing vaginal administration of misoprostol. In 106 women a dose of 800 µg was utilized, whilst in 26 women 1,200-1,600 µg were given. Nonsurgical expulsion of the fetus was successful in 117 cases (88.6%). Four cases had to be excluded for various social reasons. A total of 11 did not achieve fetal expulsion within 56 h after application of misoprostol. These cases (11/132; 8.3%) were considered failures. Previous reports in the literature of toxicity trials on animals reporting no fetotoxic nor teratogenic effects of misoprostol at doses up to 10,000 µg/kg body weight seem to be of no validity in the human since we could demonstrate that almost 80% of pregnancies were interrupted at a dose of 10–15 µg/kg body weight. The conclusion is that vaginal administration of this prostaglandin analogue, not requiring cool temperature for storage, is remarkably effective in achieving safe interruption of pregnancy without any significant complications.

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Section: Discussionmentioning

confidence: 99%

Pregnancy Interruption by Vaginal Misoprostol

Bugalho

Bique

Almeida

et al. 1993

Gynecol Obstet Invest

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“…In practice, both routes of administration of prostaglandin are not ideal. These prostaglandins are expensive, require refrigeration before use and cardiovascular complications including a maternal death from myocardial infarction after administration of sulprostone have been reported (Kalra et al 1989; Anonymous 1991).…”

mentioning

confidence: 99%

Induction of abortion with mifepristone and misoprostol in early pregnancy

Thong¹,

Baird²

1992

BJOG

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Objective To investigate the clinical efficacy of the combination of mifepristone and an orally active prostaglandin, misoprostol, for early medical termination. Design Women with amenorrhoea ≤56 days were given 200 mg mifepristone. 48 h later, 600 μg misoprostol was given orally. Setting Medical Termination Unit, Simpson Memorial Maternity Pavilion, Edinburgh. Subjects 100 women requesting medical termination of pregnancy. Interventions Evacuation of uterus for incomplete abortion or on‐going pregnancies. Results One woman had an incomplete abortion prior to administration of misoprostol. 92 (93%) out of 99 women had complete abortion following administration of misoprostol. There were three on‐going pregnancies (3.0%, 95% confidence limits (CL) 0.6‐8.6) and four incomplete abortions with this regimen (4.0%, 95% CL 1.1‐10.0). 24% women vomited and 7% had diarrrhoea following administration of misoprostol. 62% did not require any analgesia. Conclusions The combination of misoprostol with mifepristone is inexpensive, simple, effective, noninvasive and an acceptable alternative to current regimens for medical termination.

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“…The maximum Acfu Ohstet Gyiiecol Scund 71 (1YY2) (9). The frequent administration o f gemeprost may lead to an accumulation in the circulation and cardiovascular complications have been reported (10). An accumulation of gemeprost in the circulation may theoretically increase the incidence of side effects.…”

mentioning

confidence: 99%

An open study comparing two regimens of gemeprost for the termination of pregnancy in the second trimester

Thong

Baird

1992

Acta Obstet Gynecol Scand

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Two regimens of the prostaglandin E1 analogue, gemeprost, were compared in an open trial for termination of pregnancy between 12 and 18 weeks. Fifty women received 5 x 1 mg of gemeprost every 3 h and in another 50 cases, 4 x 1 mg of gemeprost was administered every 6 h. Although the median abortion interval was slightly shorter in the 3-hourly group (15.9 h vs. 16.9 h; p = 0.5), the cumulative abortion rates at 24 h were similar (88% vs. 82%; p less than 0.5). In women who aborted within the first 24 h, significantly fewer pessaries (p less than 0.01) were required to induce abortion in the 6-h treatment group (median 3, range 1-4) than the 3-h group (median 5, 2-5). Parous women in both treatment groups required fewer pessaries to induce abortion than did nulliparous women (not significant; p = 0.5). Significantly (p less than 0.01) fewer pessaries were required to induce abortion in the 6-h gemeprost group. The were no significant differences between the groups regarding incidences of diarrhea, vomiting, or the request for analgesia. These results suggest that in many women the number of pessaries used to induce mid-trimester abortion could be reduced by lengthening the interval between insertion of pessaries within the first 24 h, without loss of clinical efficacy.

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Cardiac Standstill Induced by Prostaglandin Pessaries

Cited by 19 publications

References 8 publications

Pregnancy Interruption by Vaginal Misoprostol

Pregnancy Interruption by Vaginal Misoprostol

Induction of abortion with mifepristone and misoprostol in early pregnancy

An open study comparing two regimens of gemeprost for the termination of pregnancy in the second trimester

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