Use of combination prostaglandin F2α and hypertonic saline for midtrimester abortion

Midtrimester abortion was induced by intraamniotic prostaglandin F2α in combination with hypertonic saline in 102 patients and by hypertonic saline alone in 102 others. Abortion time and duration of hospital stay were shorter with the prostaglandin-saline combination.     

Midtrimester pregnancy interruption and the placental progesterone levels.

Placental progesterone contents were studied in 10 patients therapeutically aborted at midtrimester by intraamniotic infusions of hypertonic saline, and from 14 patients (12-20 weeks) aborted by intraamniotic instillation of prostaglandin F-2alpha. The mean S.E. of the progesterone was 1.99 plus or minus 0.07 ug/g. placental tissue in the first group, while with prostaglandin abortion the placental progesterone was 1.45 plus or minus 0.08 ug/g. tissue, which is significantly lower than the results in the first group (P equals 0.001). The possible mechanism of action of prostaglandin as an effective abortifacient is discussed.     

Genital tract pressures in mares II. Changes induced by oxytocin and prostaglandin F(2)alpha

The effects of oxytocin, prostaglandin F(2)alpha and a prostaglandin F(2)alpha analogue on uterine and vaginal pressures in the mare were measured using electronic catheter-tipped pressure transducers. Catheterisation for 70 minutes produced no significant change with time. Oxytocin caused a rapid rise in intrauterine pressure which had subsided 20 minutes later. Cloprostenol (prostaglandin F(2)alpha analogue) caused an increase in uterine pressure which started ten minutes after administration and lasted for the duration of the recording (60 minutes post-injection). Prostaglandin F(2)alpha produced a uterine pressure increase ten minutes after administration which declined over the next 40 minutes. The activity of the three drugs was not consistently affected by reproductive status (oestrus, dioestrus or anoestrus). There were no significant drug effects on intravaginal pressure.     

Uterine responsiveness of oxytocin and prostaglandin F2 alpha in heat-acclimated rats

1. Contractility, in vitro, was examined in uterine horns of rats acclimated to 35 degrees C and controls (22 degrees C). 2. Responses to oxytocin and prostaglandin F2 alpha were measured in the four stages of the estrus cycle and on day 4 of pregnancy. 3. Responses to oxytocin of uteri from heat acclimated rats were significantly depressed in estrus, metestrus and diestrus, while responses to prostaglandin F2 alpha were decreased in estrus and metestrus. 4. Responses to oxytocin and prostaglandin were slightly but insignificantly decreased in uteri from pregnant day 4 heat-acclimated rats.     

Effect of beta-adrenergic stimulation on uterine contraction in response to arginine vasotocin and prostaglandin F2 alpha in the gecko Hoplodactylus maculatus.

The effects of beta-adrenergic stimulation on uterine contractions occurring in response to arginine vasotocin (AVT) and prostaglandin F2 alpha (PGF2 alpha) were compared during late pregnancy in the viviparous gecko Hoplodactylus maculatus. High doses of AVT (150 or 1,500 ng/g body weight) induced birth in vivo, but PGF2 alpha at doses of up to 2,000 ng/g did not induce birth. The effect of AVT (150 ng/g) on birth rate in vivo was not enhanced by pretreatment 20 min beforehand with the beta-adrenoreceptor antagonist dichloroisoproterenol (2 micrograms/g), whereas the effect of PGF2 alpha (200 ng/g) was markedly enhanced: geckos treated with dichloroisoproterenol and then with PGF2 alpha showed rapid birth-related behavior and gave birth. Isolated uteri showed a tonic contraction in response to AVT (100 ng/ml) and to PGF2 alpha (1,000 ng/ml). Pre-exposure of isolated uteri to the beta-adrenoreceptor agonist isoproterenol (1 microgram/ml) caused relaxation; this pre-exposure did not block the tonic contraction occurring in response to AVT, whereas it completely blocked the tonic contraction induced by PGF2 alpha. We conclude that in H. maculatus, beta-adrenergic stimulation inhibits uterine contractions induced by PGF2 alpha but not those induced by AVT. These data are the first to show that beta-adrenergic stimulation inhibits uterotonic responses to PGF2 alpha in a reptile, and they suggest that the cellular mechanisms by which AVT and PGF2 alpha induce contraction may differ in this species. They also provide further evidence for similarities between mammals and reptiles in the effects of beta-adrenergic stimulation on uterine relaxation.     

Effect of oxytocin receptor blockade on rat myometrial responsiveness to prostaglandin f(2)(alpha)

In the present study we have shown that the genetic expression of prostaglandin (PG)F(2alpha) receptor (R) and cyclooxygenase (COX)-2 increases in laboring rat myometrium. This finding was associated with a relatively weak contractile in vitro response (E:(max)) of isolated uterine strips when challenged with PGF(2alpha). Five days postpartum PGF(2alpha)-R mRNA values exceeded those during labor while COX-2 mRNA was reduced to preparturient values. Maximal contractility of isolated strips stimulated with PGF(2alpha) at this time was enhanced and E:C(50) decreased. Oxytocin treatment of estrogen-primed nonpregnant rats down-regulated uterine contractile responsiveness to PGF(2alpha), leaving mRNA values for this receptor unchanged, whereas oxytocin receptor blockade with atosiban (an oxytocin receptor antagonist) left E:(max) unaltered. In contrast, atosiban treatment of pregnant rats resulted in a 2.5-fold increase in E:(max) and a considerably reduced EC(50) during labor when compared to untreated delivering rats. The increased contractile ability was associated with a threefold increase in PGF(2alpha)-R mRNA production, indicating that the regulation by atosiban of the PGF(2alpha)-induced response is exerted at the genetic level. Based on the present data we suggest that 1) PGF(2alpha)-R stimulation may not primarily exert a contracting role in the normally delivering myometrium, and 2) the presence of the PGF(2alpha)-R system in rat myometrium may explain the apparent functional redundancy of the oxytocinergic system during the process of birth in animals lacking oxytocin or where the oxytocin receptor is blocked. In this context PGF(2alpha) receptor stimulation may, in the absence of oxytocin receptor stimulation, exert the contractile forces needed for proper propulsion of the fetus.     

Effect of polyphloretin phosphate on the response of non-gravid rat uterus to folkloric and standard oxytocics in vitro

Polyphloretin phosphate (PPP) has been reported by previous workers to be a specific antagonist of prostaglandin (PGE(1), PGE(2) & PGF(2 alpha))-induced contractions of isolated jird colon, gerbil colon, guinea pig ileum, and rabbit jejunum. In the present study, we examined the effect of PPP on uterotonic activities of crude papaya latex (a folkloric oxytocic), PGF(2 alpha), oxytocin, acetylcholine, and 5-hydroxytryptamine (standard oxytocics) on non-gravid, oestrogen-primed (50 microg/kg) rats in vitro. The effect of PPP on the oxytocics was evaluated qualitatively by incubating the tissues in PPP (25 - 400 microg/ml) for 20 min prior to the addition of a constant concentration of each oxytocic. PPP concentration dependently inhibited the contractile response of the uterine muscles to all the oxytocics. The inhibition was reversible after washing out the drugs. Results of the present study suggest that PPP is a non-specific and reversible antagonist of the response of non-gravid rat uterine smooth muscle to oxytocics in vitro. The specificity of PPP as a prostaglandin antagonist could therefore be species/tissue dependent.     

Comparison of intra-amniotic prostaglandin F2 alpha and hypertonic saline for induction of second-trimester abortion.

The efficacy and safety of intra-amniotic prostaglandin (PG) F2 alpha (25 mg repeated in six hours) and hypertonic saline (200 ml 20% NaC1) were compared in an international multicentre randomised study organised by the World Health Organisation''s prostaglandin task force. Both hypertonic saline and PGF2alpha were found to be effective in terminating second-trimester pregnancy. The main advantage of PGF2alpha however, was its greater efficacy, with significantly higher success rates in the first 48 hours. Out of 717 women given PGF2alpha 614 (85-6%) aborted within 48 hours; by 24 hours 439 (61-2%) had aborted, and by 36 hours 574 (80-1%) had aborted. Out of 796 women given hypertonic saline 641 (80-5%) aborted within 48 hours; however, by 24 and 36 hours, respectively, only 161 (20-2%) and 462 (58%) had aborted. Although PGF2alpha was associated with a somewhat higher frequency of minor side effects than hypertonic saline, notably vomiting and diarrhoea, these were within acceptable limits. Only 59 women (8-2%) in the prostaglandin group had more than four episodes of vomiting and 11 (1-5%) more than four episodes of diarrhoea. Ohter side effects occurred only occasionally. No difference was found between the two groups in the frequency of incomplete abortion or excessive bleeding.     

The use of catheter-tipped pressure transducers for chronic measurement of genital tract pressures in the ewe. II. Effects of oxytocin and prostaglandin F(2)alpha

Chronic catheterisation of the uterus, ampulla, and abdomen was performed in five ewes using solid-state, catheter-tipped pressure transducers. The catheters remained in place for up to 129 d, allowing in vivo studies of the effects of oxytocin and prostaglandin F(2)alpha (PGF(2)alpha). These agents did not produce any measurable increase in abdominal pressure. Intravenous (i.v.) oxytocin elicited a rapid increase in work done by both the uterus and ampulla. Intramuscular (i.m.) PGF(2)alpha produced a delayed uterine response but little change in the ampulla; i.v. PGF(2)alpha produced a rapid response at both sites. Low plasma progesterone concentrations (< 0.5 ng/ml) were associated with a greater uterine and ampullary response to oxytocin and with an enhanced uterine response to PGF(2)alpha. However, the uterine tube response to intravenous PGF(2)alpha was greatest when plasma progesterone concentrations were high.     

Midtrimester pregnancy interruption and the placental progesterone levels

Placental progesterone contents were studied in 10 patients therapeutically aborted at midtrimester by intraamniotic infusions of hypertonic saline, and from 14 patients (12–20 weeks) aborted by intraamniotic instillation of prostaglandin F_2∝. The mean S.E. of the progesterone was 1.99± 0.07 ug/g. placental tissue in the first group, while with prostaglandin abortion the placental progesterone was 1.45± 0.09 ug/g. tissue, which is significantly lower than the results in the first group (P=0.001). The possible mechanism of action of prostaglandin as an effective abortifacient is discussed.     

Plasma concentrations of 13, 14-dihydro-15-keto prostaglandin F(2alpha) and progesterone during oxytocin-induced oestrus in the goat

Fertile oestrus was induced in dairy goats by sub-cutaneous administration of 100 i.u. oxytocin per day between days 3-6 of the oestrous cycle. Peripheral plasma concentrations of 13, 14-dihydro-15-keto-prostaglandin F(2alpha) (PGFM), the major metabolite of prostaglandin (PG) F(2alpha), were elevated significantly (P<0.001), relative to controls, 30 minutes after oxytocin with peak values of between 300-800 pg ml(-1). Unlike control animals, plasma progesterone concentrations did not rise in the oxytocin-treated group after day 4. These results lend support to the hypothesis that the luteolytic effect of oxytocin in goats may be mediated via uterine PG production.     

Aberrations in uterine contractile patterns in mares with delayed uterine clearance after administration of detomidine and oxytocin

An experiment was conducted to determine whether the uterotonic effects of oxytocin, a drug used to treat mares that have a delay in uterine clearance were affected by the sedative detomidine (an alpha2-agonist), a drug used to treat fractious mares. An additional objective was to identify propagation patterns of uterine contractions and determine whether these patterns differed between normal mares and mares with delayed uterine clearance (DUC). Intrauterine pressure was measured in five reproductively normal mares and four mares with DUC during estrus using an 8-F Milar catheter with two discrete pressure sensors. Mares received one of three treatments in random order: detomidine (0.001 mg/kg; i.v.); detomidine followed in 10 min by oxytocin (10 IU; i.v.); and saline (0.9% NaCl 0.5 ml; i.v.) followed in 10 min by oxytocin. All treatments induced waves of contractions; however, only three mares with DUC exhibited contractions after administration of detomidine. Normal mares experienced more uterine contractions (P < 0.01) that tended to last longer (P < 0.06), and were of greater intensity (P < 0.04) than mares with delayed clearance. Administration of detomidine before oxytocin increased the number of contractions (P < 0.02) and increased the maximum intrauterine pressure in the uterine horn (P < 0.05) in normal mares as compared to response after administration of saline and oxytocin. Detomidine had no effect in mares with delayed clearance. All mares had more propagating than non-propagating uterine contractions (74 +/- 8 versus 25 +/- 8%, respectively). Normal mares exhibited a normal propagation pattern more frequently (P < 0.0001) than mares with DUC. Simultaneous (P < 0.05) and inverted (P < 0.03) contractions occurred more frequently in mares with DUC. Administration of detomidine increased the number (P < 0.01), and tended to increase the percentage (P < 0.07) of normal propagating uterine contractions in normal mares, but did not affect propagation patterns in mares with DUC. In conclusion, detomidine augmented the uterotonic effect of oxytocin in normal mares but not in mares with DUC. Data suggest that mares with DUC have a defect in myoelectrical signaling and a decrease in the contractile strength of the uterine muscle.     

Evidence for a systemic role for ovarian oxytocin in luteal regression in sheep

Jugular venous concentrations of oxytocin and progesterone changed in parallel during the oestrous cycle in the ewe, falling at luteal regression and rising with formation of the new corpus luteum. These fluctuations in the circulating concentration of oxytocin were not caused by changes in its metabolic clearance rate. On Days 6-9 of the cycle circulating oxytocin concentrations exhibited a diurnal rhythm, peaking at 09:00 h; this rhythm was absent on Days 11-14. Although there was no evidence for increased production of oxytocin at or preceding luteal regression in samples taken daily, more frequent sampling revealed that two thirds of detected surges of uterine secretion of prostaglandin (PG) F-2 alpha were accompanied by raised levels of oxytocin. This oxytocin was not of pituitary origin. Luteal regression induced with cloprostenol on Day 8 after oestrus caused a decrease in circulating progesterone level followed after 24 h by a fall in oxytocin. Measurements of oxytocin in the ovary and other organs before and after treatment with cloprostenol identified the corpora lutea as a major potential source of oxytocin, and suggested that 98% of luteal oxytocin was available for secretion in response to prostaglandin stimulation. The data are consistent with a role for ovarian secretion of oxytocin in response to uterine release of PGF-2 alpha in the control of luteal regression.     

Effects of mepacrine on uterine contractile responses

Mepacrine is a potent inhibitor of uterine contractile responses in vitro. Pretreatment of isolated rat uterine horns with mepacrine (1.3 X 10(-4)M) for periods of time ranging from 15 s to 5 min prior to the addition of carbachol (1.0 X 10(-4)M) showed that mepacrine could significantly reduce carbachol-induced uterine contractile responses within 15 s of exposure. The maximal inhibitory effects of mepacrine on uterine contractile responses were observed within 2 min of mepacrine treatment. A dose-response study related to the effect of increasing concentrations of mepacrine (7.5 X 10(-6) to 1.3 X 10(-4)M) on carbachol-induced (1 X 10(-4)M) uterine contractions revealed that a dose of 3.1 X 10(-5)M mepacrine reduced the carbachol-induced contraction by 50%. A dose of 7.8 X 10(-5)M mepacrine produced the maximal inhibitory effect on the carbachol-induced uterine contractions. Two doses of mepacrine (3.1 X 10(-5) and 1.3 X 10(-4)M) significantly reduced maximal contractile responses and shifted contractile dose-response curves of carbachol, oxytocin, prostaglandin F2 alpha, and BaCl2 to the right. Based on the nonselective inhibition by mepacrine of contractile responses induced by different uterotonic agents, these results suggest that mepacrine cannot be used to characterize the role of phospholipase in regulating the actions of hormones in uterine tissue.     

Differential effects of progesterone treatment on the oxytocin-induced prostaglandin F2 alpha response and the levels of endometrial oxytocin receptors in ovariectomized ewes.

The oxytocin-induced uterine prostaglandin (PG) F2 alpha response and the levels of endometrial oxytocin receptors were measured in ovariectomized ewes after they had been given steroid pretreatment (SP) with progesterone and estrogen to induce estrus (day of expected estrus = Day 0) and had subsequently been treated with progesterone over Days 1-12 and/or PGF2 alpha over Days 10-12 postestrus. The uterine PGF2 alpha response was measured after an i.v. injection of 10 IU oxytocin on Days 13 and 14, using the PGF2 alpha metabolite, 13,14-dihydro-15-keto-PGF2 alpha (PGFM), as an indicator for PGF2 alpha release. The levels of oxytocin receptors in the endometrium were measured on Day 14. During the treatment with progesterone, the peripheral progesterone concentrations were elevated and remained above 1.8 ng/ml until the morning of Day 14. The PGFM responses to oxytocin in untreated controls and SP controls were low on both Days 13 and 14 whereas the levels of endometrial oxytocin receptors in the same ewes were high. Treatment with progesterone either alone or in combination with PGF2 alpha significantly (p less than 0.04) increased the PGFM response on Day 14 and reduced the levels of endometrial oxytocin receptors; treatment with PGF2 alpha alone had no effect. It is concluded that progesterone promotes the PGFM response to oxytocin while simultaneously suppressing the levels of endometrial oxytocin receptors. PGF2 alpha treatment had no effect on either the uterine secretory response to oxytocin or the levels of oxytocin receptors in the endometrium.(ABSTRACT TRUNCATED AT 250 WORDS)     

Action of GABA-positive preparations on uterus-stimulating effects of activating neuromediators, prostaglandin F2 alpha and oxytocin]

Experiments on isolated strips of the non-pregnant rabbit and rat uterus showed the ability of dopamine, noradrenaline, serotonin, acetylcholine, prostaglandin F2 alpha, oxytocin to increase the uterine strips contractile activity. On the other hand, GABA, GABAB receptors agonist phenibut and diazepam inhibit the stimulating effects of the above mentioned substances, thus showing the properties of physiological antagonists of these neuromediators, prostaglandin and oxytocin.     

The hormonal control of birth behavior in the gray short-tailed opossum (Monodelphis domestica)

In all major groups of Australian marsupials, prostaglandin F2alpha (PGF) or oxytocin injection initiates birth behavior in adult females, adult males and pouch young. Because inhibitors of PGF synthesis block this initiation, oxytocin may activate birth behavior via the stimulation of PGF synthesis. In this study, the role of PGF and oxytocin in the activation of birth behavior was examined in an American marsupial, the gray short-tailed opossum (Monodelphis domestica). Adult male and female gray opossums were given PGF, oxytocin, or saline (control) before behavioral observation. On the next day, the animals in the oxytocin group were injected with the PGF inhibitor flunixin meglumide (Finadyne, Schering Corp., U.S.A.) before oxytocin reinjection and behavioral observation. Both males and females showed birth behavior in response to PGF but only females responded to oxytocin. There was no significant difference in the latency of response of females to oxytocin alone versus response to oxytocin after receipt of the PGF inhibitor. These results suggest that, in contrast to Australian species, in this American marsupial, oxytocin initiates birth behavior only in females and does not operate via stimulation of prostaglandin secretion.     

Uterine and placental prostaglandins and their modulation of oxytocin sensitivity and contractility in the parturient uterus

The parturient uterus develops a markedly enhanced sensitivity to the uterotonic action of oxytocin (OT). The mechanism leading to this enhanced OT sensitivity is not known. Our previous work suggested that prostaglandins (PGs) may be involved. To define the relationship between OT sensitivity and uterine PG production, we measured uterine sensitivity to OT by a quantitative dose-response procedure in rats on Days 19, 20, 21 and 22 of pregnancy and monitored uterine and placental tissue concentrations of PGF2 alpha and PGE2. In addition, we determined the effects of inhibition of endogenous PG synthesis on OT sensitivity and uterine contractility. We found that both OT sensitivity and spontaneous contractility are positively related to uterine PGF2 alpha production. An abrupt increase in OT sensitivity was observed on Days 21 and 22 of pregnancy. The increase in OT sensitivity was coincidental with the marked increase in PGF2 alpha production in the uterus on Days 21 and 22 of pregnancy. Suppression of in vivo PG synthesis caused a reduction in both spontaneous uterine contractility and OT-induced contractions. Uterine PGE2 concentrations and release were 3-5 times lower than PGF2 alpha. There were no significant fluctuations of uterine PGE2 concentration measured on these last 4 days of gestation. Placental PG levels were also found not to be related to uterine contractility. Placental PGE2 levels were higher than PGF2 alpha and may play a regulatory role in placental perfusion. However, placental PGs did not vary with gestational age.     

The ovarian and cervical regions of the rat uterus display a different contractile response to serotonin and prostaglandin F2alpha. I. The estrous cycle

In pharmacological studies using isolated tissues, the sensitivity to different agonists may vary depending on the anatomical region. The aim of the present study was to evaluate the in vitro contractile response to serotonin, prostaglandin F2alpha, and oxytocin of the ovarian and the cervical uterine segments isolated from rats in the four different stages of the rat estrous cycle. Non-cumulative curves were recorded for both, the ovarian and the cervical uterine segments. The cervical portion displayed a higher contractile response to serotonin and a lower response to PGF2alpha than the ovarian portion. Oxytocin induced similar responses in both uterine segments. The uterine ovarian segment displayed a similar sensitivity to serotonin in all the estrous cycle stages, whereas in the cervical segment, influenced by estrogens in diestrus and proestrus, an increase in contractility was observed. According to these findings, serotonin might participate in the spermatozoa transport toward the oviduct. The higher response of the ovarian portion to prostaglandin F2alpha is in line with its role during labor and delivery.