Gemeprost abortion

In a double-blind, randomized, controlled trial, 896 healthy women requesting a medical abortion (57-63 days gestation, mean age 25 years) were randomized to a single oral dose of mifepristone 200 or 600 mg, both followed in 48 hours by gemeprost 1 mg vaginally (2). The complete abortion rates were similar with the lower and higher doses of mifepristone (92 versus 92%). The incidences of adverse effects were similar, with the exception of nausea at 1 week, which was less frequent in the low-dose group (3.6 versus 7.6%). 

The author commented that the myocardial ischemia experienced by both of these patients was thought to be due to prostaglandin-induced coronary spasm. It would be prudent to monitor every woman treated with gemeprost during the course of an abortion. 

Lecorvaisier-Pieto C, Joly P, Thomine E, Tanasescu S, Noblet C, Lauret P. Toxic epidermal necrolysis after mife-pristone/gemeprost-induced abortion. J Am Acad Dermatol 1996 35(1) 112. 

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). 

Ripening of the cervix was started with a pessary of gemeprost 1 mg. After 3 hours, when the cervix was 1 cm dilated, an intramuscular injection of sulprostone 500 mg was given. After 30 minutes she developed persistent abdominal pain, which became a continuous cramping and then a shooting pain a male fetus of 170 g was aborted. There was a 3 cm longitudinal cervical rupture located posteriorly that reached the posterior fornix. 

For mid-trimester medical abortion (13-24 weeks), mifepristone 600 mg by mouth followed 36-4 8 hours later by gemeprost 1 mg every... 

Gemeprost (prostaglandin Ej analogue) (Cervagem) is used intravaginally to soften the cervix before operative procedures in the first trimester of pregnancy and for abortion, alone and in combination with an antiprogestogen (mifepristone, p. 720). 

The other main class of agent used for contractile actions on the uterus are the prostanoids. They may be used together with oxytocin for the induction of labour. Some are also used for therapeutic abortion e.g. gemeprost. See prostanoid RECEPTOR AGONISTS. 

Gem-dimethyl can also constitute solutions to introduce symmetry into a chiral center, or to protect a close and sensitive function, as in the case of gemeprost, an analog of prostaglandin Ei used in medical abortion, where the gem-dimethyl groups at C-16 protect the alcohol moiety at C-15 from rapid metabolic oxidation. ... 

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