摘要:

Abstract.In this survey the effect of intracervically applied prostaglandin E2(PGE2) on the pregnant uterus is outlined. It is concluded that PGE2decreases cervical resistance and stimulates the myometrium to contract. In small doses (0.25 mg and 0.5 mg) PGE2produces a rapid and prominent ripening of the cervix without systemic side effects and independent of prominent uterine contractions. Prostaglandin E2applied intracervically in viscous gel seems to be superior to previously used methods for treatment of patients with an unfavorable cervical state.

ISSN:0001-6349    

DOI:10.3109/00016347909156814

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Abstract.Prostaglandin E2(PGE2) suspended in a viscous gel was deposited intracervically to 115 patients at term with an unripe cervix. 45 of these patients were given a single dose of 1.0 mg PGE2, whereas the remaining 70 received only half that dose, i.e. 0.5 mg. Irrespective of dose<60 per cent of the patients were induced into labor and delivered without further stimulation within less than 24 hours. The mean induction delivery time was 10 hours. In the remaining patients a considerable ripening of the cervix was registered. Hypercontractility did occur in one patient given 1.0 mg PGE2, otherwise no maternal side effects were observed. There were no adverse effects on the fetuses. The number of instrumental deliveries was 19 per cent including 9 per cent cesarean sections.It is concluded that locally applied PGE2‐gel can be used to produce ripening of the cervix and/or induce labor in patients at term with an unripe cervix. Since there was practically no difference in efficiency between the two doses but one case of hyperstimulation in patients given 1.0 mg PGE2, the smaller dose, i.e. 0.5 mg is recommende

ISSN:0001-6349    

DOI:10.3109/00016347909156815

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Abstract.In a randomized double‐blind study a viscous gel, containing 0.25 mg prostaglandin E2(PGE2‐gel) or without prostaglandin (placebo gel), was applied intracervically in twenty‐two nulliparous patients just before termination of early pregnancy by dilatation and evacuation (D&E). Within twelve hours a marked ripening of the cervix was found in all the eleven patients receiving PGE2‐gel. Thus, a significant change in cervical dilatation from mean 5.4 mm to mean 10.7 mm occurred. Furthermore, a considerable softening of the cervix was registered. In the eleven patients receiving placebo gel, no significant changes in cervical dilatation or consistency were found. The subsequent D&E was easily performed in all patients treated with PGE2‐gel. However, in three of the patients given placebo gel, D&E was difficult to carry out because of an unfavorable cervical state.To eliminate or decrease myometrial activity the calcium antagonist nifedipine was given orally to eight patients at application and five hours after application of 0.25 mg PGE2‐gel. None of the patients recognized uterine contractions. However, also in these patients significant changes in cervical consistency and dilatation occurred within twelve hours. No side effects of the treatment were observed.It is concluded, that a preoperative, intracervical single application of 0.25 mg PGE2seems to be useful to ripen the unfavorable cervix before subsequent termination of early pregn

ISSN:0001-6349    

DOI:10.3109/00016347909156816

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Abstract.A new gel‐formulation for intracervical application of prostaglandin E2(PGE2) has been prepared. As a vehicle for the gel a cross‐link starch polymer is used. PGE2substance is added to the starch polymer and after homo‐genization and lyophilization a PGE2powder is obtained. The powder can be stored at room temperature for more than four months without inactivation of the prostaglandin. Before clinical application a few ml of saline is added to the powder giving, within 30 seconds, an easily‐handled ready to use PGE2‐gel. Chemical analysis by spectrophotometric technique reveals that the amount of unchanged PGE2is the same in the new gel‐formulation as in a conventional cellulose gel.In a randomized double‐blind study the new PGE2‐gel was intracervically applied to twenty nulliparae before abortion by dilatation and evacuation (D&E). Ten women were given a gel containing 0.25 mg PGE2(PGE2‐gel) and ten a gel without PGE2(placebo gel). It was found that the PGE2‐gel, in contrast to the placebo gel, produced a rapid ripening of the cervix facilitating the subsequent D&E. No adverse systemic or local reactions were found during or

ISSN:0001-6349    

DOI:10.3109/00016347909156817

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY