Mid-trimester abortion with intra-amniotic prostaglandin F2 alpha and intravenous oxytocin infusion

Induction of abortion in mid-trimester pregnancies were performed on 26 patients. The first 12 patients were treated by intra-amniotic instillation of Prostaglandin F2 alpha, with a mean dosage of 40.2 mg. and mean abortion time of 24 hours and 41 minutes (ten patients). Fourteen additional mid-trimester abortions were performed using identical protocol plus the addition of oxytocin by intravenous infusion two hours after injection of the prostaglandin. All patients aborted, with mean dosage of PGF2 alpha of 28.2 mg. and mean abortion time of 15 hours and 37 minutes.     

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.     

Changes in estrogen levels in maternal venous plasma after intra-amniotic infusion of prostaglandin F2 for therapeutic abortion

Peripheral plasma levels of estrone, estradiol-17beta and estriol were measured by the method of Shutt and Cox in 10 women following intra-amniotic infusion of prostaglandin F2alpha (PGF2a) for therapeutic abortion. Initial dose was 30 mg, followed if necessary, by doses of 15 mg at 24 hours and 42 hours. Gestational age of pregnancies ranged from 14 to 19 weeks, with a mean of 16 weeks. All 10 women completely aborted. Mean induction-abortion interval was 24 + or - 12 hours. The mean estrone, estradiol 17beta and estriol levels declined to about half of the pre-infusion levels after 80% of the induction-abortion interval had elapsed. The main decline in estrogen levels occurred in individual women either during the 1st quarter or during the last quarter of the induction-abortion interval. There were no significant relationships between changes in estrogen levels and the interval from 1st administration of PGF2a to subsequent abortion.     

Induction of therapeutic abortion using either extra-amniotic prostaglandin F-2-alpha or hypertonic saline followed by oxytocin

160 women with uteri at 10-20 weeks gestation were treated with either PG(prostaglandin)F2alpha or saline solution followed by oxytocin to effect an abortion. 80 women were in each treatment group. The distribution of the patients according to age, parity, and gestation duration is tabulated. PGF2alpha was administered extraovularly in a concentration of .1 mg/ml with .7 mg being injected in the operating theater and nurses administering the rest based on response to previous injections. Administration continued for up to 30 hours. Saline was given in a volume in ml dependent on the duration of pregnancy multiplied by a factor of 10. Subcutaneous injections of oxytocin were given on subsequent days to speed the abortion. 85% of the PG patients successfully aborted without surgical dilatation of the cervix. The average dosage of PG required was 7.5 mg in 11 instillations. Side effects and complications in the PG group were minimal. 1 instillation of saline followed by 2 days of oxytocin were required to effect a 79% abortion rate in the saline group. Although the number of patients requiring surgical dilatation was the same for both groups, the procedure was much less time-consuming for the PG group. The complication rate was 26% for the saline group as compared to 14% for the PG group. The PG group required a shorter hospital stay.     

Mid-trimester abortion with 15 (S) methyl prostaglandin F 2 alpha

The efficacy of intramuscular administration of 15 methyl (15S) prostaglandin F2alpha (PGF2a) in midtrimester pregnancy termination was evaluated in 16 healthy patients (mean age, 23.3; mean parity, 1.4; mean number of menstrual weeks, 16.1) by measuring dose response; oxytocin conversion; abortion time; side effects; intrauterine dynamics and progesterone withdrawal. Labor was monitored using extraovular balloon placed transvaginally; transcervically; and connected to a Physiograph machine. Patients not aborting within 48 hours after the first dose were considered failures. Blood samples were collected at 0, 3, and 6 hours and at abortion time for plasma progesterone measurement. Average dose given was 789 +or- 60 micrograms. Only 9 of 10 patients aborted within the prescribed 48 hours: 7 were complete abortions, and 2 were incomplete and required suction curettage. Mean induction to abortion time was 20.2 +or- 2.7 hours. Nausea, vomiting and diarrhea were the main side effects. The findings suggest that 15 methyl PGF2a in the dosages and routes prescribed is not as efficient as PGF2a. It is also suggested that prostaglandin affects the myometrium at 2 levels: 1) a membrane effect, and 2) a more fundamental intracellular regulatory effect which is necessary to initiate labor.     

Doses of prostaglandin F(2)alpha effective for induction of estrus in goats

A total of 11 cycling does weighing between 24 and 50 kg were injected with varying dosages of prostaglandin F(2)alpha (PGF(2)alpha) between 7 and 10 days into each estrous cycle. Five injections each of 1.25, 2.5, 5.0, or 7.5 mg PGF(2)alpha were alternated with five injections of 1.0 ml saline. Saline treated does served as controls. All does were teased twice daily with a buck and observed for signs of estrus for 5 days post-injection. Daily systemic concentrations of progesterone (P(4)) were determined by radioimmunoassay. The mean (+/- S.E.) hours from injection to estrus was 47 +/- 3.3, 42 +/- 4.3, 44 +/- 8.5, and 43 +/- 5.5 for does receiving 1.25, 2.5, 5.0, and 7.5 mg PGF(2)alpha, respectively. None of the does receiving saline exhibited estrus in the 5-day post-injection observation period. Mean (+/- S.E.) concentrations of systemic P(4) in all does on the day of injection was 4.22 +/- 0.45 ng/ml. Concentrations 24 hours post-injection were 0.21 +/- 0.02, 0.15 +/- 0.05, 0.17 +/- 0.04, 0.16 +/- 0.04, and 4.5 +/- 1.36 ng/ml for does receiving 1.25, 2.5, 5.0, and 7.5 mg PGF(2)alpha, and 1.0 ml saline, respectively. The results suggested that 1.25 mg PGF(2)alpha was effective for induction of estrus in the cycling goat.     

Role of prostaglandin F2alpha in ovulation.

Using radioimmunoassay procedures, the levels of plasma, uterine and ovarian prostaglandin (PG) F2alpha, and those of plasma estradiol and progesterone were measured in intact, hysterectomized or ovariectomized immature female rats pretreated with PMS and subsequent HCG. Occurrence of ovulation was confirmed at 8 hours after the HCG administration not only in the intact rats but also in the hysterectomzied rats. The levels of plasma estradiol and progesterone, and of uterine and ovarian PGF2alpha rose with the PMS injection alone, but they did not reach the peaks before the HCG administration. Both plasma estradiol and uterine PGF2alpha showed a peak at 2 hours after the HCG injection. These peaks were antecedent 2 or 6 hours before the peaks of ovarian and plasma PGF2alpha, respectively. However, such increase of uterine PGF2alpha does not seem to be indispensable for ovulation, because ovulation could occur in the hysterectomized rats. The levels of ovarian PGF2alpha showed a high plateau from 4 to 8 hours after the HCG injection, and then rapidly decreased after ovulation. The levels of plasma PGF2alpha peaked not only in the intact rats but also in the hysterectomized rats at 8 hours after the HCG treatment. But in the ovariectomized rats, this plasma PGF2alpha peak at 8 hours disappeared and there was no statistical change of plasma PGF2alpha throughout the PMS-HCG treatment. Plasma progesterone gradually increased and reached the maximum at 10 hours after the HCG injection. These results conclude that the main source of increased plasma PGF2alpha during the ovulatory process induced with the PMS-HCG treatment is the ovary, and it is strongly suggested that a rapid increase of PGF2alpha in the ovary may play some important role(s) in the ovulatory process.     

Histophysiological studies of prostaglandin F2alpha on isolated organs. I. Effect of prostaglandin F2alpha on the heart.

The physiological and histochemical effects of PGF2alpha on isolated rabbit hearts were examined. The results showed a positive inotropic effect. The coronary flow increased. From the histochemical studies, adenosine triphosphatase (ATP-ase) and succinic dehydrogenase activities were increased while that of alkaline phosphatase was decreased. Glycogen granules were depleted. These findings were discussed on a histophysiological basis.     

The induction of labour by the intravenous infusion of prostaglandin F2alpha

Labour was induced by the intravenous infusion of prostaglandin F2alpha in 106 patients at 36-44 weeks of pregnancy. The induction was successful in 80% of the women. The total dose needed ranged from 0.1 to 14.2 mg of PGF2alpha. The uterine activity and fetal heart rate were recorded by cardiotocography. The contraction pattern and induction-delivery time were the same as reported for induction with oxytocin. In one case uterine hyperactivity occurred after rupture of the membranes. No serious adverse effects were seen, but in a few cases local irritation was noted at the site of infusion. The condition of the infants was generally good. It might be concluded that PGF2alpha seems valuable for the induction of labour, but due to the risk for over-stimulation careful supervision is needed.     

Induction of abortion with prostaglandin F(2)alpha in gilts and their subsequent fertility

Fourteen gilts were aborted (some of them repeatedly) by i.m. administration of 500/ug cloprostenol (PG) between 30 and 100 days of pregnancy so that the total number of PG-induced abortions was 19. Six of these gilts were allowed to terminate their subsequent pregnancy by farrowing. It was found that In a Trial under semi-production conditions the mean birth body mass of piglets from 11 gilts bred after previous PG-induced abortion was 1.48 kg as compared to 1.19 kg in the controls. The difference was significant (P<0.01).     

Peroxisomal chain-shortening of prostaglandin F2 alpha

We have recently reported that prostaglandin F2 alpha can be chain-shortened by isolated rat liver peroxisomes. In the present study it is further established by cell fractionation experiments that the enzymes involved in this reaction are localized to peroxisomes. Under the conditions employed, the highest activity was found in the light mitochondrial fraction. Further fractionation of the light mitochondrial fraction by sucrose density gradient centrifugation showed that the prostaglandin oxidation activity comigrated with peroxisomal marker enzymes. Di(2-ethylhexyl)phthalate treatment resulted in a tenfold increased capacity for the conversion of prostaglandin F2 alpha into tetranorprostaglandin F1 alpha. The reaction was not inhibited by KCN. The reaction was further characterized with respect to cofactor requirements. The prostaglandin oxidation was found to be completely dependent on NAD, CoA, ATP, Mg2+ and was stimulated by FAD. Incubation of prostaglandin E2 with peroxisomes resulted in conversion into several products. After alkaline hydrolysis, one of these was identified as tetranorprostaglandin B1.