Uterine vein prostaglandin levels in late pregnant dogs

We studied the uterine venous plasma concentrations of prostaglandins E₂, F_2α, 15 keto 13,14 dihydro E₂ and 15 keto 13,14 dihydro F_2α in late pregnant dogs in order to evaluate the rates of production and metabolism of prostaglandin E₂ and F_2α in pregnancy $\text{in vivo}$. We used a very specific and sensitive gas chromatography-mass spectrometry assay to measure these prostaglandins. The uterine venous concentrations of prostaglandin E₂ and 15 keto 13,14 dihydro E₂ were 1.35±.27 ng/ml and 1.89±.37 ng/ml, respectively; however, we could not find any prostaglandin F_2α and very little of its plasma metabolite in uterine venous plasma. Since uterine microsomes can generate prostaglandin F_2α and E₂ from endoperoxides, prostaglandin F_2α production $\text{in vivo}$ must be regulated through an enzymatic step after endoperoxide formation. Prostaglandin E₂ is produced by pregnant canine uterus in quantities high enough to have a biological effect in late pregnancy; however, prostaglandin F_2α does not appear to play a role at this stage of pregnancy.     

Effects of analogues of prostaglandins E2 and F2α on uterine luminal fluid accumulation in the estrogen-treated ovariectomized rat: An indirect measure of cervical tone

Experiments were performed to determine if prostaglandins were able to reduce cervical tone in the rat. Cervical tone was assessed indirectly by measuring uterine luminal fluid accumulation in ovariectomized rats implanted subcutaneously with Silastic capsules containing crystalline estradiol-17β. When given subcutaneously in separate experiments, 16,16-dimethyl-prostaglandin E₂, methyl ester, and 15(S)-15-methyl-prostaglandin F_2α, analogous of prostaglandins E₂ and F_2α, respectively, caused the loss of uterine luminal fluid. Fluid accumulation in uterine horns ligated at the cervical end did not differ in control and treated rats, whereas in non-ligated horns the prostaglandin analogues reduced fluid accumulation, suggesting the cervix as their site of action. For both prostaglandin analogues, the effects on uterine luminal fluid accumulation were seen within 45 min of administration and were related to the dose administered. The effects of submaximal doses of the analogues were additive. These results suggest that prostaglandins are able to reduce cervical tone in the estrogen-treated rat.     

Oestrus synchronization in buffaloes (Bubalus bubalis)

A study was conducted on 34 Surti buffalo cows to determine the feasibility of synchronizing oestrus using prostaglandin F_2α and a 12-day progesterone intravaginal device. Eighteen cycling buffalo cows having palpable corpora lutea were treated with a single intramuscular injection of 30 mg of prostaglandin F_2α. Three cows exhibited oestrus approximately 54 h after treatment and two of these were diagnosed pregnant 90 days after natural breeding. Sixteen randomly selected post partum cows were treated for 12 days with a progesterone intravaginal device. Ten mg of oestradiol 17β in 5 ml of ether was also injected at the time of insertion of the device. Thirteen cows retained the device for 12 days and 10 of them returned to oestrus 4–5 days after its removal. Eight animals were diagnosed pregnant 90 days after natural breeding. The results indicate that short term progesterone intravaginal device treatment is more reliable than prostaglandin for synchronizing oestrus in buffaloes.     

Oral Administration of Prostaglandins for the Induction of Labour

Prostaglandins E₂ and F₂α administered by mouth were used to induce labour in 100 patients between 35 and 44 weeks of gestation. The usual effective dose of prostaglandin E₂ was 0·5 and of F₂α 5 mg. These were repeated every two hours until labour was established. Induction was successful in 79 out of 80 women treated with oral prostaglandin E₂ and in 16 out of 20 women treated with F₂α     

Comparison of the actions of the 15-methyl analogs of prostaglandins E2 and F2α on hormone levels after their administration for therapeutic abortion

Plasma levels of progesterone, total estrogens and HCG were measured after the administration of 15 (S) 15-methyl prostaglandin E₂ methyl ester (15-methyl PGE₂) or 15 (S) 15-methyl prostaglandin F_2α free acid (15-methyl PGF_2α) for therapeutic abortion during the first trimester of pregnancy. 15-methyl PGE₂ given intramuscular (im) in a dose of 50μg resulted in the termination in pregnancy in four out of five patients; these subjects exhibited falls in hormone concentrations. However, an im injection of 500μg 15-methyl PGF_2α did not affect the hormone levels nor did it produce abortion in any of the five subjects studied. The results confirm that 15-methyl PGE₂ is a potent abortifacient and this action may be related to an effect that this compound has on hormone production by the corpus luteum or the feto-placental unit; 15-methyl PGF_2α does not share the same action in the dose range investigated.     

Termination of molar pregnancy by intramuscular administration of 15(S)-15-methyl-prostaglandin F2α

Eleven patients entered a multicentre trial of repeated intramuscular injections of 15(S)-15-methyl-prostaglandin F2α (15-me-PGF2α) for terminating molar pregnancy. Duration of pregnancy ranged from 9 to 24 (median: 16) weeks and uterine size from 15 to 24 (median: 19) weeks. Complete (n=5) or incomplete (n=4) expulsion of molar tissue occurred in 9 patients (82%) after a median duration of 15.7 hours. In the remaining 2 patients treatment was interrupted after 8 hours at a cervical dilatation of 1 cm or more. Gastro-intestinal side effects were prominent in 64%. The use of prostaglandins in the management of hydatidiform mole is discussed.     

Therapeutic Abortion by Intra-amniotic Injection of Prostaglandins

Intra-amniotic injection of either prostaglandin F₂α or prostaglandin E₂ was used in an attempt to induce therapeutic abortion in mid-pregnancy in 27 patients. Termination of pregnancy was successful in 11 out of 13 cases when prostaglandin E₂ alone was used, but in only 6 out of 14 cases when prostaglandin F₂α was used. A further eight patients aborted after additional intravenous oxytocin stimulation, but the combined procedures failed altogether in two patients who were initially given prostaglandin F₂α. The technique was simple, free from serious side effects, and reasonably effective when prostaglandin E₂ was used.     

Maternal and fetal prostaglandin concentrations during late gestation in dairy cattle

A study was conducted to measure the blood plasma concentrations of prostaglandin F_2α (PGF_2α), 13,14-dihydro-15-keto-prostaglandin F_2α (PGFM), prostaglandin E₂ (PGE₂) and 13,14-dihydro-15-keto-prostaglandin E₂ (PGEM) in the jugular vein, umbilical vein and artery and uterine vein of 18 Holstein Friesian cows during late gestation. A caesarean section was performed on all cows before term in order to obtain blood samples from the different sources. Plasma PG concentrations in the uterine or fetal circulation were significantly higher than in jugular vein plasma. Correlations between peripheral PG metabolite concentrations and primary PG concentrations in the various sources of the uterus or fetus were not significant (r = .17 − .47) and demonstrated that prostaglandin values based upon peripheral blood alone are of limited value.     

Partial purification and some properties of human erythrocyte prostaglandin 9-ketoreductase and 15-hydroxyprostaglandin dehydrogenase.

Human erythrocytes were found to contain two prostaglandin metabolizing enzymes: a prostaglandin E 9-ketoreductase catalyzing the reduction of prostaglandin E₂ to form prostaglandin F_2α and a 15-hydroxyprostaglandin dehydrogenase that catalyzes the oxidation of prostaglandin F_2α to form 15-ketoprostaglandin F_2α. Both enzymes are found in the cytoplasmic fraction of erythrocytes and both enzymes use the triphosphopyridine nucleotides as cofactors more effectively than the diphosphopyridine nucleotides. These two enzymes were partially purified from erythrocyte homogenates and some of their properties were studied.     

Serial intramuscular injections of 15(S)-15-methyl-prostaglandin F2α in the induction of abortion

Abortion was successfully induced in 62 of 68 patients in the 9th to the 26th week of pregnancy by serial intramuscular administration of 15(S)-15-methyl-prostaglandin F_2α (15-ME-PGF_2α). In 6 patients who failed to abort after 24 hours of prostaglandin administration, a concomitant infusion of oxytocin was initiated; 5 of these patients aborted within 12 hours of the combined therapy. A single patient failed to abort, even with the combined therapy, and underwent surgical evacuation. The mean abortion time in the 67 successful inductions was 14.56 hours. Parous patients aborted somewhat faster, mean 13.98 hours, as compared to nulliparous patients, mean 15.02 hours, but this difference was not statistically significant. In this study initial intramuscular injection of 100 μg 15-ME-PGF_2α was followed in 1 hour by 250 μg and then 250 μg every 2 hours with concomitant oxytocin therapy initiated after 24 hours. The results with this dose schedule were compared to the results obtained in a previous study with a higher dose schedule, an initial dose of 100 μg 15-ME-PGF_2α, followed in 1 hour by 250 μg then 500 μg every 2 hours. There was no significant difference in the mean abortion time and the incidence of side effects between the 2 dose schedules. The mean abortion time for patients with gestational ages of 16 weeks and less was the same with both dose schedules, however patients with gestational ages of 17 weeks and higher aborted somewhat faster with the higher dose schedule. It might therefore be advisable for patients with gestations of 17 weeks and higher to be treated with the higher dose schedule. In earlier gestations patients could be started on the lower schedule, and if abortion had not occurred within 15 hours the dose of 15-ME-PGF_2α could then be increased to 500 μg every 2 hours.     

Induction of midtrimester abortion by serial intravaginal administration of 15(S)-15-methyl-prostaglandin F2α (THAM) suppositories

Midtrimester abortion was successfully induced in 13 of 22 patients by serial intravaginal administration of 15(S)-15-methyl-prostaglandin F_2α (THAM) suppositories. Nine patients, 4 nulliparas and 5 multiparas, failed to abort after 24 hours of prostaglandin administration and a concomitant infusion of oxytocin was initiated. Seven of the nine patients aborted within 7 hours of the combined therapy and one patient on methadone maintainence aborted after 17.5 hours of combined therapy, 41.5 hours after the first dose of prostaglandin. A single patient failed to abort, despite the concomitant prostaglandin-oxytocin administration and underwent surgical evacuation. The mean abortion time for the 21 successful abortions was 22.56 hours. Nulliparous patients aborted somewhat faster, mean 21.79 hours, than multiparous patients, mean 23.80 hours, but this difference was not statistically significant. In this study, one patient aborted in less than 12 hours, and 62% of the successful cases aborted within 24 hours. The plasma levels of 15-ME-PGF_2α were analyzed by radioimmunoassay in 10 patients. Plasma prostaglandin levels rose significantly 30 minutes after the insertion of the first suppository, but there was a wide variation in levels from patient to patient. It was observed that the 2 patients with the highest levels had the fastest abortion times and episodes of gastro-intestinal side effects appeared related to a rise in prostaglandin levels. Sixty-four percent of the patients in this study had no gastro-intestinal side effect related to prostaglandin administration.     

Luteolytic action of 15-keto prostaglandin F2α in the rhesus monkey

The naturally-occurring metabolite of prostaglandin F_2α, 15-keto prostaglandin F_2α (15-keto PGF_2α), elicited rapid and sustained declines in serum progesterone concentrations when administered to rhesus monkeys beginning on day 22 of normal menstrual cycles. Evidence for luteolysis of a more convincing nature was obtained in studies where a single dose of 15-keto PGF_2α was given on day 20 of ovulatory menstrual cycles in which intramuscular injections of hCG were also given on days 18–20; serum progesterone concentrations fell precipitously in monkeys within 24 hours following intramuscular administration of 15-keto PGF_2α. However, corpus luteum function was impaired in only 4 of 11 early pregnant monkeys when 15-keto PGF_2α was administered on days 30 and 31 from the last menses, a time when the ovary is essential for the maintenance of pregnancy. Gestation failed in 2 additional monkeys 32 and 60 days after treatment with 15-keto PGF_2α, but progressed in an apparently normal manner in the remaining 5 animals. Two pregnant monkeys treated with 15-keto PGF_2α on day 42 from the last menstrual period, a time when the ovary is no longer required for gestation, continued their pregnancies uneventfully. Corpus luteum function was not impaired in 9 control monkeys which received injections of vehicle or hCG at appropriate times during the menstrual cycle or pregnancy.     

Oxytocin Release by Infused Prostaglandin

Plasma oxytocin levels were measured serially in 22 women receiving prostaglandin E₂ or F_2α intravenously for the induction of labour. Oxytocin was detected in the plasma of 19 of the 22 women; positive levels were found in 60 (43%) of 139 plasma samples, an incidence similar to that in the late first stage of spontaneous labour. Oxytocin was found in the maternal plasma even when the fetus was dead, and in the plasma of two men receiving prostaglandin infusions. This indicates that prostaglandins stimulate the pituitary directly and suggests that this mechanism may play a part in the oxytocic action of infused prostaglandins.     

Effect of partial fetectomy on plasma 13,14-dihydro-15-keto-prostaglandin F2α in late pregnancy of sows

The aim of this study was to ascertain if partial fetectomy in late pregnancy affected prostaglandin F_2α levels, thereby influencing the time of delivery of the remaining fetuses in the sow. Sham fetectomy or surgical removal of one, two, three or four fetal piglets was performed on each of ten sows during the last 3 weeks of pregnancy. Removal of no fetuses (two sows) and in one sow a single fetus was followed by a continuation of pregnancy to the expected time of parturition. Plasma values for oestrone, progesterone and 13,14-dihydro-15-keto-prostaglandin F_2α (PGFM) were similar to those reported previously for normal sows. Removal of one (two sows), two (two sows), three (two sows) or four (one sow) fetuses was followed by premature parturition, within 42–144 h of surgery. Labour lasted 24 to 30 h. Almost immediately after fetectomy, PGFM levels in plasma increased and were accompanied by a decline in progesterone concentrations. High PGFM values (13–60 ng/ml) were present at parturition. Oestrone concentrations were variable or rose slightly at this time. The results suggest that all fetuses in a litter must be present to maintain pregnancy to term. Pregnancy may depend upon fetal suppression of prostaglandin F_2α production and release until the appropriate time for parturition.     

Induction of abortion with intra-amniotic or intra-muscular 15(S)-15-methyl-prostaglandin F2α

In order to evaluate the efficacy and acceptability of 15(S)-15-methyl-prostaglandin F_2α (15-me-PGF_2α) for pregnancy termination, we induced 30 abortions with single intra-amniotic injections of 2,5 mg of 15-me-PGF_2α and 25 abortions with intra-muscular 15-me-PGF_2α administered 200 g initially and 300 g every third hour until 30 hrs or abortion. Abortion occurred within 30 hrs in 97 % of cases in the intra-amniotic group, with a mean abortion time of 17,6 hrs and in 80 % in the intramuscular group, with a mean abortion time of 15.0 hrs. Neither parity nor gestational age was significantly related to the abortifacient efficacy of 15-me-PGF_2α. No serious complications occurred. Vomiting (83–84 %) and diarrhoea (23–92 %) were the most common complaints. Uterine contractions were more painful if induction was effected with intra-amniotic rather than intramuscular injections. 15-me-PGF_2α appears to be an effective and practicable abortifacient which can be used intra-amniotically or intramuscularly according to the ease of amniocentesis.     

Induction of abortion with intra-amniotic or intra-muscular 15(S)-15-methyl-prostaglandin F2α

In order to evaluate the efficacy and acceptability of 15(S)-15-methyl-prostaglandin F_2α (15-me-PGF_2α) for pregnancy termination, we induced 30 abortions with single intra-amniotic injections of 2,5 mg of 15-me-PGF_2α and 25 abortions with intra-muscular 15-me-PGF_2α administered 200 μg initially and 300 μg every third hour until 30 hrs or abortion. Abortion occurred within 30 hrs in 97 % of cases in the intra-amniotic group, with a mean abortion time of 17,6 hrs and in 80 % in the intramuscular group, with a mean abortion time of 15.0 hrs. Neither parity nor gestational age was significantly related to the abortifacient efficacy of 15-me-PGF_2α. No serious complications occurred. Vomiting (83–84 %) and diarrhoea (23–92 %) were the most common complaints. Uterine contractions were more painful if induction was effected with intra-amniotic rather than intramuscular injections. 15-me-PGF_2α appears to be an effective and practicable abortifacient which can be used intra-amniotically or intramuscularly according to the ease of amniocentesis.     

Blood pressure and heart rate effects of prostaglandin E2 and F2α produced by intracerebroventricular injections in cats

Blood pressure and heart rate effects of prostaglandin E₂ and F_2α were examines after administrating each agent into the left lateral brain ventricle of chloralose-anesthethized cats. Administration of prostaglandin E₂ (1 μg) resulted in significant, prolonged increases in arterial pressure (25.7 ± 6.7 mm Hg) and heart rate (19.4 ± 7.7 beats/min). These responses were mimicked when the same dose of prostagland E₂ was administered into the restricted to the lateral and third ventricles via cannulation of the cerebral aqueduct, whereas no significant cardiovascular occured with administration into the fourth ventricle. Intravenous injection of prostaglandin E₂ resulted in a transient decrease in blood pressure but no change in heart rate. Administration of prostaglandin F_2α (1 and 3 μg) into the CNS produced no significant cardiovascular responses. The same was true when prostaglandin F_2α was administered by the intravenous route. These results indicate that pronounced cardiovascular effects can be produced by administering prostaglandin E₂ but not F_2α into the CNSm and that the central site of action of prostaglandin E₂ is in the forebrain.     

Levels of prostaglandin F2α in amniotic fluid during pregnancy and labour

Levels of prostaglandin F_2α (PGF_2α) in the amniotic fluid were determined by radioimmunoassay. Concentrations of the prostaglandin were relatively constant between 15 and 35 weeks' gestation, but an increase was observed after 36 weeks. The rise was continued up to 44 weeks. A still greater elevation of PGF_2α levels was recorded during labour, when the levels were related to the amount of cervical dilatation.Amniotic fluid PGF_2α levels in toxaemia of pregnancy did not significantly differ from those found in normal pregnancy.     

The influence of prostaglandins on sperm motility

Prostaglandin E₂ and F_2α were measured in ejaculates from 10 fertile and 55 infertile men. Prostaglandin F_2α was negatively correlated with motility (r=0.77; p<0.01) in normal men. In patients with disturbed fertility, prostaglandin F_2α was always higher than in the controls, while prostaglandin E₂ was elevated only in patients with persisting varicocele and in those with very low sperm counts and severely impaired motility. There was neither synthesis of prostaglandins in spermatozoa nor were binding sites for prostaglandin E₂ and F_2α detectable. Inactivation of seminal prostaglandins by incubation with prostaglandin 15-hydroxydehydrogenase resulted in a dramatic fall in motility. The results suggest that prostaglandin F_2α act on motility, but the action is not mediated by receptors.     

The effect of a 10 cm2, 0.5% 15-ME-PGF2α methyl ester intravaginal silastic device on abortion and plasma prostaglandin concentration

Intravaginal insetion of a 10 cm² silastic device with an 0.5% concentration of 15(S)-15-methyl-prostaglandin F_2α methyl ester alone successfully induced abortion in 27 of 48 patients in the midtrimester and in an additional 11 patients with a concomitant infusion of oxytocin. The mean abortion time for the 38 successful induction was 15.35 hours. In 8 of the 10 patients who failed to abort even with concomitant oxytocin therapy, abortion was induced by serial intramuscular injections of 15-ME-PGF_α; the remaining 2 failures underwent surgical evaccution. The plasma levels of 15-ME-PGF_2α methyl ester in the 11 patients studied varied widely over the first 2 hours after insertion of the device. The maximum mean level was achieved at 2 hours, maintained at 4 hours and then dropped sharply at 8 hours and declined over the abortion period in undelivered patients. Vomiting and diarrhea were the most common side effects and in general well tolerated by the patients. However, there was an adverse reaction in a single patient who experienced almost constant nausea, vomiting and diarrhea. The device was removed 1 hour 50 minutes after insertion and the patient aborted spontaneously 7 hours later. Intravaginal insertion of a silastic device is an effective means of prostaglandin abortion, but their investigation is required to determine the most effective device which would provide a slow, continuous release of the prostaglandin.