Abortion, induction

Robins J, Surrago EJ. Alternatives in midtrimester abortion induction. Obstet Gynecol 1980 56(6) 716-22. 

E. Schiff, S. Lipitz, G. Ben-Baruch, A. Chetrit, G. Oelsner and J. Menczer, Midtrimester abortion induction with intraamniotic prostaglandin F2 alpha in women with previous uterine surgery, J. Reprod. Med., 1991, 36, 198-200. 

Before starting an IV infusion of oxytocin for the induction of labor, the nurse obtains an obstetric history (parity, gravidity, previous obstetric problems, type of labor, stillbirths, abortions, live birth infant abnormalities)... 

Although fruit and vegetable quality has been the main thrust of this review it should not be forgotten that the quality of flower bulbs are also of major importance, especially in countries such as the Netherlands where export markets in tulips are commercially significant. Bud abortion is a disorder of tulips associated with a dehydrated flower after planting, while induction often takes place during storage. In an attempt to use MRI as a possible detector of... 

Prostaglandins are involved, along with oxytoxin and steroids, in control of parturition. They result in contraction of the uterine muscles and dilation of the cervix (the neck of the womb). This effect is very powerful since the maximum dilation is an increase in diameter of about 10 cm. Prostaglandins were first used for induction of abortion in the UK in 1972. 

Oxytocin is used for the induction of labor, or augmentation of labor in selected patients with uterine dysfunction, and to prevent or control bleeding after birth or abortion. Demoxytocin, a synthetic oxytocin has similar activities as oxytocin. 

Oxytocin is used in induction of labour, in postpartum haemorrhage, abortion and in breast engorgement. It is used by IM/IV route (PITOCIN, 2-5 lU/ml inj). 

Indications Induction and augmentation of labor management of postpartum bleeding and adjunctive therapy in the management of incomplete or inevitable abortion... 

F. Role in therapy According to Micromedex, oxytocin is routinely used for the induction of labor at term and postpartum for the control of uterine bleeding. Oxytocin is not the drug of choice for induction of labor for abortion. Oxytocin infusion has been used following prostaglandin or hypertonic abortifacients to shorten the induction to abortion time when inducing second-trimester abortion, inducing abortion when a patient has failed to respond to the abortifacient, or to induce abortion after membranes have ruptured. 

Dinoprostone, a synthetic preparation of PGE2, is administered vaginally for oxytocic use. In the USA, it is approved for inducing abortion in the second trimester of pregnancy, for missed abortion, for benign hydatidiform mole, and for ripening of the cervix for induction of labor in patients at or near term. 

First- and second-trimester abortion Cervical reopening Induction of labor Augmentation of labor Postpartum hemorrhage Ectopic pregnancy Lactation suppression In gastrointestinal disease Peptic ulceration Liver transplantation Chemotherapy-induced mucosal lesions In cardiovascular disease Congenital cardiac malformations Raynaud s syndrome Chronic obstructive pulmonary disease Adult respiratory distress syndrome Pulmonary hypertension Arterial occlusive disease Extracorporeal circulation In urology Erectile dysfunction... 

Contraction of the non-pregnant uterus Induction of abortion and labor Prostaglandin F series... 

When PGE2 and PGF2a are used for induction of labor and abortion, the following contraindications must be respected and (until proven otherwise) also apply to the methyl analogues of these two prostaglandins ... 

Prostaglandins have been used intravenously, both for induction of mid-trimester abortion and for induction of labor in cases of intrauterine death. The same adverse effects as described above occur, and are usually very pronounced. Routine premedication with an antiemetic and an antidiarrheal agent significantly reduces gastrointestinal adverse effects. 

Sederberg-Olsen J, Olsen CE. Prostaglandin-oxytocin induction of mid-trimester abortion complicated by grand mal-like seizures. Acta Obstet Gynecol Scand 1983 62(1) 79-81. 

Vaginal misoprostol is more effective and better tolerated than oral misoprostol for induction of first and second trimester abortions after the administration of mifepristone (1,2). It is more effective than either gemeprost or sulprostone combined with mifepristone for induction of first trimester abortion, although uterine rupture has been reported (3). 

Intramuscular methotrexate 50 mg/m2 followed by intravaginal misoprostol was effective in the induction of first trimester abortion. Adverse events following the administration of misoprostol included nausea (12%), vomiting (8.1%), diarrhea (7.4%), and fevers/chills (3.4%) (4). 

Jain JK, Mishell DR Jr. A comparison of misoprostol with and without laminaria tents for induction of second-trimester abortion. Am J Obstet Gynecol 1996 175(1) 173—7. 

Searle GD. Important drug warning concerning unapproved use of intravaginal or oral misoprostol in pregnant women for induction of labor or abortion. Media Release 23 August 2000. 

A rare case of a non-metastatic gestational trophoblastic tumor after induction of early abortion with mifepristone and misoprostol has been reported (20). 

There has sometimes been reluctance to use higher doses of mifepristone, because of a supposedly greater risk of severe adverse effects. However, in a randomized comparison of a single oral dose of mifepristone (either 200 mg or 600 mg) followed 48 hours later by oral misoprostol 400 pg the two regimens produced identical results as regards the induction of abortion and the incidence of adverse effects (22). 

Prostaglandin E2 (PGE2) is an agent used to ripen the cervix for the induction of labor (it is also used for second-trimester abortion) and shows various beneficial effects ... 

The next target is the gestation process itself. As outlined above, a number of alkaloids are mutagenic and lead to malformation of the offspring or directly to the death of the embryo (Table V). The last step would be the premature abortion of the embryo. This dramatic activity has been reported for a number of allelochemicals, such as mono- and sesquiterpenes and alkaloids. Some alkaloids achieve this by the induction of uterine contraction, such as the ergot and lupine alkaloids (312). 

Oxytocin is used i.v. in the induction of labour and sometimes for uterine inertia, haemorrhage or during abortion. It produces, almost immediately rhythmic contractions with relaxation between, i.e. it mimics normal uterine activity... 

---