Laminaria augmentation of intra-amniotic PGF2α for midtrimester pregnancy termination

In our hands, intra-amniotic PGF₂α 40 mg for midtrimester pregnancy termination had a mean infusion to abortion interval of 29.4 hr. However, pretreatment of 230 patients with laminaria tents inserted 14–18 hr before PGF₂α infusion resulted in a dramatically reduced time to abortion (14.3 hr mean) with a low incidence of gastrointestinal and other side effects. Laminaria tents inserted at the same time as PGF₂α infusion in 26 patients also resulted in reduced time to abortion (18.6 hr mean). In the laminaria pretreated group, the infusion to abortion interval was indirectly related to the number of laminaria inserted and not to the nulliparous or parous state. Although we have made significant strides in shortening the abortion interval in the hospital, retained placentae and blood loss persist as problems related to the use of prostaglandin for abortion.     

Intra-amniotic prostaglandin F2α and urea for abortion

Prostaglandin F_2α (PGF_2α) 20 mg combined with urea 80 g was injected intra-amniotically in 20 patients to induce mid-trimester abortion. Abortion resulted in all subjects within 24 hours in a mean time of 12 hours 38 minutes (range 5 hours 50 minutes to 20 hours 45 minutes).Plasma sex steroids were evaluated before and hourly for 5 hours after the injection. A progressive decline in levels occurred with time. Decreases in plasma progesterone, estrone, estradiol and estriol were significant as soon as one hour after injection.Gastrointestinal side effects occurred with a greater frequency than when a comparable dose of PGF_2α is given alone and 2 patients had small cervical lacerations requiring suture. Further studies are indicated to establish whether a lower dose of PGF_2α will be associated with fewer side effects and be as effective.     

Induction of term labor with intravenous prostaglandin F2α (a comparison of two dosage schedules)

The efficacy of intravenous Prostaglandin F_2α (PGF_2α) infusion for induction of labor in two different dosage schedules was studied in 90 women between 36 and 43 weeks of gestation. The rate of PGF_2α infusion was increased at four-hour intervals in 36 women in the low dosage group and every hour in 54 women in the high dosage group, never exceeding an infusion rate of 20 μg/min. in either group. Labor was successfully induced in approximately 90% of the patients in each group. There was no statistically significant difference in the mean induction-delivery interval between the two groups at the 5 percent level. Intravenous PGF_2α was found to be effective and safe for both mother and infant in the dosage schedules used in this study for induction of labor.     

Prostaglandin F2α for the induction of labor in pregnancies complicated by intra-uterine death, anencephaly and chromosomal anomaly

A group of 10 patients, with pregnancies of varying gestational age, complicated by missed abortion, intra-uterine death, anencephaly and chromosomal anomaly, underwent induction of labor by intra-amniotic prostaglandin F_2α infusion. Induction of labor was successful in all cases and the side-effects were mild. The induction-delivery interval did not differ significantly from that recorded when labor in such cases has been induced by intravenous PGF_2α.The induction-delivery interval showed no apparent relation to the state of the fetus (living or dead) suggesting that no significantly active role is mediated by the fetus in PGF_2α-induced labor.     

Prostaglandin E2: Midterm abortion in rats using Silastic-PVP tubes

The results of the present study establish that 1.5 mg PGE₂ (lyophilized sodium salt) incorporated in one cm long open-ended Silastic-polyvinylpyrrolidone (PVP) tube when inserted into 10 day pregnant rats induced abortion within 70–72 hours in all the treated rats. A combined treatment of PGE₂ and 17β-estradiol failed to increase the abortion inducing effect of a Silastic-PVP-PGE₂ tube. It is observed that PGE₂ is about 4 times less potent than PGF_2α in inducing midterm abortion in rats. It is suggested that either PGE₂ exerts luteolytic effect after being converted to PGF_2α, although how it occurs is not clear; or PGE₂ causes expulsion of the fetuses by its uterine stimulating property. 17β- estradiol increases the uterine synthesis of PGF_2α as described earlier but seems not affecting the production of PGE₂ by the uterus. The release rate of ³H-PGE₂ from Silastic-PVP tube and is also described.     

Increased blood LH and testosterone after administration of prostaglandin F2α in bulls

Two types of experiments were conducted to determine the relationship of changes in blood luteinizing hormone (LH) and testosterone in bulls given prostaglandin F_2α (PGF_2α). Episodic surges of LH and testosterone occurred in tandem, apparently at random intervals, on the average once during the 8-hr period after bulls were given saline. In contrast, after sc injection of 20 mg PGF_2α, blood serum testosterone increased synchronously to a peak within 90 minutes four-fold greater than pre-injection values, and the testosterone surges were prolonged about three-fold compared to those in controls. Each of the PGF_2α-induced surges of testosterone was preceded by a surge of blood serum LH which persisted for about 45 minutes and peaked at about 3 ng/ml. In a second experiment, PGF_2α was infused (iv, 0.2 mg/min) for 20 hr; blood plasma testosterone increased from 7.0 ± 0.6 to 16.0±1.5 ng/ml within 2.5 hr and remained near this peak for 10 hr. Then testosterone gradually declined to about 9 ng/ml at the conclusion of the 20-hr infusion. These changes in testosterone were paralleled by similar changes in blood plasma LH, although LH declined 3 hr earlier than testosterone. Random episodic peaks of blood plasma LH and testosterone typical of untreated bulls resumed within 8 hr after conclusion of PGF_2α infusion. In both experiments, the surge of testosterone after PGF_2α was preceded by increased blood LH. We conclude that increased LH after administration of PGF_2α probably caused the increased testosterone. However the mechanisms of these actions of PGF_2α remain to be determined.     

Role of progesterone in regulating uteroovarian venous concentrations of PGF2 α and PGE2 during the estrous cycle and early pregnancy in ewes

The role of progesterone in regulation of uteroovarian venous concentrations of prostaglandins F₂ α (PGF₂α) and E₂ (PGE₂) during days 13 to 16 of the ovine estrous cycle or early pregancy was examined. At estrus, ewes were either mated to a fertile ram or unmated. On day 12 postesturus, ewes were laparotomized and a catheter was inserted into a uteroovarian vein. Six mated and 7 unmated ewes received no further treatment. Fifteen mated and 13 unmated ewes were ovariectomized on day 12 and of these, 7 mated and 5 unmated ewes were given 10 mg progesteron sc and an intravaginal pessary containing 30 mg of progesterone. Uteroovarian venous samples were collected every 15 min for 3 h on days 13 to 16 postestrus. Mating resulted in higher mean daily concentrations of PGE₂ in the uterovarian vein than in unmated ewes. Ovariectomy prevented the rise in PGE₂ with day in mated ewes but had no effect in unmated ewes. Progesterone treatment restored PGE₂ in ovariectomized, mated ewes with intact embros. Mating had no effect on mean daily concentrations of PGF₂α or the patterns of the natural logarithm (ln) of the invariance of PGF₂α. Ovariectomy resulted in higher mean concentrations and ln invariances of PGF₂α on day 13 and lower mean concentrations and ln invariances of PGF₂α on days 15 and 16. Replacement with progesterone prevented these changes in patters of mean concentrations and ln variances of PGF₂α following ovariectomy. It is concluded that progesterone regulates the release of PGF₂α from the uterus, maintaining high concentrations while also preventing the occurrence of the final peaks of PGF₂α which are seen with falling concentrations of progesterone. This occurs in both pregnant and non-pregnant ewes. Progesterone is also needed to maintain increasing concentrations of PGE₂ in mated ewes.     

Dose and time dependent luteotropic and luteolytic action of prostaglandin F2α in the luteinized rabbit ovary

The mechanism of stimulatory and inhibitory action of PGF_2α on ovarian steroidogenesis both under and conditions has been studied in the pseudo-pregnant rabbits. Short term incubation of the ovaries with PGF_2α (2.82 × 10⁻⁵M) resulted in an increased synthesis of progesterone and 20α-OH P. The addition of PGF_2α in the medium and further incubation of the ovaries obtained from rabbits that had been constantly infused with PGF_2α (0.5 μg/min.) for two hours resulted in increased synthesis of these progestins. The ratio of progesterone to 20α -OH P was also enhanced under these conditions and thus supported the luteotropic action of small doses of PGF_2α under short term incubations. However, as the amount of PGF_2α infused was increased to 5 μg/min., the addition of PGF_2α under conditions strikingly decreased the production of these progestins. The ratio of progesterone to 20α -OH P was also decreased and thus was indicative of luteolytic action of higher doses of PGF_2α. High doses of PGF_2α (5.64 × 10⁻⁴M) failed to I cause any significant change in the progestin synthesis under short term incubation. These results thus suggest that the luteotropic and luteolytic action of PGF_2α in the luteinized rabbit ovary is dose and time dependent.     

Effect of in vivo prostaglandin treatment on H-PGF2α uptake in hamster corpora lutea

Pregnant hamsters were administered (SC) prostaglandin or vehicle on the morning of the 4th day of pregnancy. Serum progesterone was significantly depressed (p<.01) at 0.5, 2, and 6 hours after treatment with 100 μg PGF_2α. Serum progesterone levels were unchanged 2 hours and 6 hours after treatment with 100 μg PGF_2β and 2 hours after treatment with 1 mg PGF_2β. Progesterone levels were depressed to less than 1 ng/ml 6 hours after treatment with 1 mg PGF_2β. The specific uptake of ³H-PGF_2α in whole hamster corpora lutea was significantly depressed 2 hours and 6 hours following 100 μg PGF_2α treatment. A 15% depression in specific uptake occurred 0.5 hour post-treatment. Treatment with 100 μg PGF_2β resulted in no change. Administration of 1 mg PGF_2β resulted in depressed ³H-PGF_2α uptake at both 2 and 6 hours post-treatment.Prostacyclin (PGI₂) treatment resulted in no change in either ³H-PGF_2α specific uptake or serum progesterone 2 hours after 100 μg treatment SC. These parameters were both reduced approximately 30% 6 hours post-treatment. Treatment with 6-keto-PGF_1α resulted in a complete lack of measurable ³H-PGF_2α uptake and serum progesterone levels less than 1 ng/ml at both 2 and 6 hours after treatment with 1 mg SC.     

Metabolism of prostacyclin. III. Urinary metabolite profile of 6-keto PGF1α in rat

The in vivo metabolism of 6-keto PGF_1α was investigated in rats. Following continuous intravenous infusion for 14 days the urinary metabolites were isolated and identified. A substantial amount of unchanged 6-keto PGF_1α was recovered in the urine. The metabolic pattern very closely resembles that of PGI₂ in rats. Metabolites were found which represented 15-dehydrogenation, β-oxidation, ω and ω-1-hydroxylation and oxidation.Previous work showed that 6-keto PGF_1α is very poorly oxidized by 15-PGDH. We administered 15-[H³]-PGI₂ and 15-[H³]-6-keto PGF_1α to rats and measured urinary tritiated water as an index for in vivo 15-PGDH activity. The results showed that PGI₂ and 6-keto PGF_1α were both oxidized to the 15-keto product, although the rate of oxidation of PGI₂ was greater than that of 6-keto PGF_1α. We concluded that the administered PGI₂ was oxidized by 15-PGDH before hydrolysis to 6-keto PGF_1α. A portion of the dose is probably hydrolyzed before 15-dehydrogenation.     

Failure of exogenous LH to prevent PGF2α-induced luteolysis in beef cows

Henderson and McNatty (Prostaglandins 9:779, 1975) proposed that LH from the preovulatory LH surge attached to receptors on luteal cells and that this attachment might protect the early corpus luteum from PGF_2α induced luteolysis. To test this hypothesis, experiments were performed on heifers at day 10–12 of the cycle. Both jugular veins were catheterized and infusions of either saline (0.64 ml/min) or LH-NIH-B9 (10 μg/min; 0.64 ml/min) were given. Saline infusions were from 0–12 h; LH infusions were for 10 h and were preceded by a 2 h saline infusion. All animals were given 25 mg PGF_2α im at 6 h (6 h into the saline infusion and 4 h into the LH infusion). Blood samples were taken at 0.5 h, 1 h and 4 h intervals from 0–12, 13–18 h and 22–24 h respectively. Serum was assayed for LH and progesterone by radioimmunoassay methods. Two animals received saline and two received LH in each experiment. Eact treatment was replicated 6 times. LH infusion resulted in a mean serum LH of 57 ng/ml compared to 0.90 ng/ml in saline infused animals. This elevation of LH did not alter PGF_2α induced luteolysis as indicated by decline in serum progesterone. This experiment does not support the hypothesis that the newly formed corpus luteum is resistant to PGF_2α because of protection afforded by the protestrus LH surge.     

Luteolysis, estrus and ovulation, and blood prostaglandin F after intramuscular administration of 15, 30 or 60 mg prostaglandin F2α

During diestrus in three consecutive estrous cycles, each of six heifers was given (im) 30 mg, 15 mg (twice at 6-hr intervals) and 60 mg prostaglandin F_2α (PGF_2α) tham salt. Neither the decline in blood progesterone, the increase in blood estradiol, the duration or the peak of the LH surge, the interval to onset of estrus, nor the interval to ovulation was affected significantly by dose of PGF_2α. Thus, relative to that after 30 mg PGF_2α im, two injections of 15 mg at 6-hr intervals or 60 mg PGF_2α did not hasten luteolysis. Thirty mg was an ample im dose of PGF_2α to cause luteolysis. Regardless of im dose of PGF_2α, blood PGF peaked at about 6.0 ng/ml within 10 minutes and returned to basal values (<1.0 ng/ml) within 90 minutes. In another trial, after a single iv injection of 5 mg PGF_2α, blood PGF peaked (25 ng/ml) within 5 minutes and returned to basal values within 15 minutes. During a 30-minute infusion (0.5 mg/minute) of PGF_2α, blood PGF plateaued at 29.5 ng/ml with a metabolic clearance rate of 17.0 liters per minute.     

Midtrimester abortion induced by serial intravaginal administration of prostaglandin E2 suppositories in conjunction with a contraceptive diaphragm

Midtrimester abortion was successfully induced in a series of 20 patient by intra-amniotic instillation of 15(S)-15-methyl-prostaglandin F_2α with a mean abortion time of 17.78 hours. The patients in this study were divided into two groups, Groups I received on initial dose of 2.5 mg 15-ME-PGF_2α and aborted in a mean time of 16.26 hours. The patients in Group II received 3.0 mg 15-ME-PGF_2α and aborted in a mean time of 18.94 hours. There was no significant difference in the abortion time, occurrence of side effects or the initiation of uterine activity between Group I and Group II. Parous patients aborted somewhat faster than nulliparous patients but this difference was not significant. In this study 80% of the patients aborted in 24 hours or less, and the intra-amniotic instillation of 15-ME-PGF_2α was an effective abortifacient technique from the 15th to the 23rd week of gestation. The uterine response to intra-amniotic instillation of 15-ME-PGF_2α was characterized by the gradual appearance of low amplitude, high frequency contractions accompanied by a rise in baseline intrauterine tonus. Uterine activity developed gradually and peaked at 1:50 hours after intra-amniotic instillation of 15-ME-PGF_2α. In this small series 15-ME-PGF_2α administered via intra-amniotic instillation did not appear to have a distinct advantage over the naturally occurring PGF_2α administered by the same method for the induction of midtrimester abortion; a larger series is indicated to define the advantages of either technique.     

Midterm abortion in hamsters induced by Silastic-PVP-PGE2 tubes

Intrauterine insertion of a 0.5 cm long Silastic-PVP tube containing 750 μg PGE₂ (lyophilized sodium salt) caused midterm abortion in hamsters within 48 hours. An earlier study using a similar Silastic-PVP tube delivery system showed that 200 μg of PGF_2α (Tham) was sufficient to induce abortion in 100% of pregnant hamsters (18). Prostaglandin E₂ is, therefore, about 3.5–4 times less potent than PGF_2α as an abortifacient in the hamster. The release of ³H-PGE₂ from Silastic-PVP tube and is also described. It is suggested that an increase in LH release might be one of the factors leading to luteolysis; and that either PGE₂ exerts a direct luteolytic effect or this effect is manifested after its being converted to PGF_2α.     

Radioimmunoassays of prostaglandin F2α and prostaglandin F2α-main urinary metabolite with prostaglandin-I-tyrosine methylester amide

Radioimmunoassays for measuring prostaglandin F_2α (PGF_2α) and 5α, 7α-dihydroxy-11-keto tetranorprosta-1,16-dioic acid, PGF_2α-main urinary metabolite (PGF_2α-MUM), with ¹²⁵I-tyrosine methylester amide (TMA) of PGF_2α and PGF_2α-MUM were developed.Antibody to PGF_2α was produced in rabbits immunized with conjugates of PGF_2α coupled to bovine serum albumine. Antibody to PGF_2α-MUM was also produced in rabbits immunized with conjugates of PGF_2α-MUM coupled to bovine serum albumin.PGF_2α-¹²⁵I-TMA had an affinity to antiserum to PGF_2α. PGF_2α-MUM-¹²⁵I-TMA also responded to antiserum to PGF_2α-MUM.     

Effect of PGF2α on progesterone secretion and adenylate cyclase activity in ovine luteal tissue

Ovine luteal slices were used to study the effects of prostaglandins (PG) F₂α on luteinizing hormone (LH)-stimulated secretion of progesterone and adenylate cyclase activity. The accumulation of progesterone in incubation medium and adenylate cyclase activity was similar after incubation of luteal slices with Medium 199 alone or Medium 199 containing PGF₂α (250 ng/ml) for 3 hr. Addition of luteinizing hormone (LH; 100 ng/ml) resulted in a 2–3 fold increase in both the rate of progesterone accumulation and adenylate eyclase activity by 3 hr. When luteal slices were incubated in the presence of both LH and PGF₂α the rates of progesterone accumulation and adenylate cyclase activity were identical to those in flasks containing LH alone after 1 hr; however, after 3 hr both LH stimulated progesterone accumulation and adenylate cyclase activity were inhibited to levels similar to those observed in control slices.In a second experiment, after 60–120 min of exposure to PGF₂α the rate of progesterone accumulation in the medium was not different from that in untreated control slices. In addition, after this experiment the luteal slices were homogenized and the basal, sodium fluoride, LH, isoproterenol (ISO) and PGE₂ sensitive adenylate cyclase activities were determined to evaluate the hormonal specificity of the negative effect of the pretreatment with PGF₂α. Both LH and ISO stimulated adenylate cyclase activities were reduced after PGF₂α pretreatment. However, fluoride ion stimulated adenylate cyclase activity was not significantly effected by PGF₂α pretreatment and PGE₂ sensitive adenylate cyclase was effected only slightly.     

Sperm output and serum testosterone in rabbits given prostaglandin F2α or E2

Two experiments were conducted, the first to compare sperm output and the second to determine serum testosterone in rabbits given PGF₂α or PGE₂. In the first, six rabbits were ejaculated twice each Monday, Wednesday and Friday for 5 weeks. Each rabbit was given subcutaneously (sc) each of the following treatments five times: 1) saline, 2) 5 mg PGF₂α and 3) 5 mg PGE₂. Treatments were given, half at 4 hr and half at 2 hr before first ejaculations. Both PGF₂α and PGE₂ caused increased (50% and 84%) sperm content of first ejacula, without significantly altering characteristics of second ejacula. The extra sperm in first ejacula was a function of increased sperm density, because seminal volume was unaltered.In the second experiment, 15 rabbits were bled at 0.5-hr intervals for 9 hr and given (sc): 1) saline at 1 and 3 hr (n=4), 2) 2.5 mg PGF₂α at 1 and 3 hr (n=4), 3) 2.5 mg PGE₂ at 1 and 3 hr (n=4) or 4) 5 mg PGF₂α at 1 hr after the onset of blood sampling. In saline-treated controls, episodic surges of testosterone occurred on the average every 5 hours. After the injection of 2.5 or 5.0 mg PGF₂α, serum testosterone began to rise at 0.5 hr, peaked (8 to 13 ng/ml) at 1 hr and approached a nadir (0.5 ng/ml) within 4 hours. The second injection of 2.5 mg PGF₂α failed to significantly affect serum testosterone. PGE₂ treatment was followed by significantly depressed serum testosterone; only 1 of these 4 rabbits had any surge of testosterone for the 8 hr after treatment. In conclusion, PGF₂α and PGE₂ both increased sperm output, but PGF₂α increased serum testosterone while PGE₂ depressed serum testosterone. Thus, the sperm output effect of these prostaglandins probably is independent of the acute changes in testosterone secretion.     

Activation of phospholipase D by prostaglandin F2α in rat luteal cells and effects of inhibitors of arachidonic acid metabolism

In rat luteal cells labeled with (³H]oleic acid, PGF_2α-stimulated phospholipase D (PLD) activation was investigated. The PLD activity was detected by measuring the accumulation of [³H]phosphatidylethanol (PtdEt) in the presence of ethanol. PGF_2α stimulated PtdEt accumulation at concentrations of more than 100 nM in the presence of ethanol. However, PtdEt accumulation did not change in the absence of ethanol. PGF_2α (1 μM) increased PtdEt accumulation after 1 min, and the accumulation reached a plateau by 2–3 min. These results indicate that PGF_2α activates PLD in rat luteal cells. U-73122, a phospholipase C (PLC) inhibitor, and staurosporine, a protein kinase C (PKC) inhibitor, did not inhibit PGF_2α-stimulated [³H]PtdEt accumulation. These results suggest that PGF_2α-induced PLD activation is different from PLC-PKC systems. We reported previously that PGF_2α stimulated the release of arachidonic acid. The effects of indomethacin, nordihydroguaiaretic acid (NDGA), and 5,8,11,14-eicosatetraynoic acid (ETYA), inhibitors of arachidonic acid metabolism, on PGF_2α-stimulated PtdEt accumulation were examined. Pretreatment with indomethacin enhanced PGF_2α-induced PtdEt accumulation. In contrast, pretreatment with NDGA and ETYA inhibited PGF_2α-induced PtdEt accumulation. It is suggested that PGF_2α-stimulated PLD activation is mediated via lipoxygenase products.     

Mating increases plasma levels of prostaglandin F2α in female garter snakes

Plasma levels of prostaglandin F_2α (PGF_2α) in female red-sided garter snakes (

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) were measured at intervals after mating or exposure to males. PGF_2α levels increased significantly within 15 minutes of mating and peaked 6–24 hr after mating. Females that did not mate, but received similar amounts of male courtship, had levels of PGF_2α significantly lower than those of females that mated. These results extend previous findings that unmated female garter snakes injected with PGF_2α exhibit sexual behavior characteristics of females that have mated. Together these data indicate that female garter snakes elaborate PGF_2α in response to stimuli associated with mating and that PGF_2α has a functional role in inducing post-mating declines in sexual behavior of this species.     

Effects of dibuturyl cAMP, LHRH, and aromatase inhibitor on simultaneous outputs of prostaglandin F2α, and 13,14-dihydro-15-keto-prostaglandin F2α by term placental explants

Explants from term human placentas were maintained in culture with daily changes of medium. Daily output of PGF_2α and PGFM¹ decreased during the course of the incubation. Addition of 4 μg/ml DHEAS or 67 μg/ml LDL cholesterol had no effect on output of PGF_2α or PGFM. Addition of 1.6, 3.2, or 6.4 μg/ml of LHRH to the culture plates had no effect on output of PGFM or PGF_2α, but LHRH increased hCG output. Dibutyryl cAMP (1mM, 2mM, and 4mM) increased output of PGF_2α, PGFM, and hCG. Aromatase inhibitor decreased hCG output, but it was without effect on output of PGF_2α, or PGFM. Significant correlations were demonstrated between progesterone, PGFM, PGF_2α, and hCG, suggesting that PGF_2α originates in the syncytiotrophoblast cell. The ability of LHRH to stimulate output of hCG but not PGF_2α while dbcAMP stimulated both suggests that either PGF_2α and hCG arise in different cells or that LHRH does not act through cAMP.