Pregnancy termination

Prior to undergoing medical termination of pregnancy, women must be informed about this rare complication. If a vaginal infection is present, antibiotics are indicated. Ideally, all women should be screened for infection and treated before termination of pregnancy. However, in practice, this is rarely done. In Europe, routine prophylactic antibiotic treatment is not uncommon [53]. 

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Another approach to pregnancy termination has been the utilization of progesterone synthesis inhibitors. These compounds block production of progesterone by the corpus luteum and the early placenta. When adrninistered with a prostaglandin, their use can result in medically induced abortions. 

Stehn, R. A. and Richmond, M. E. (1975). Male-induced pregnancy termination in the prairie vole, Microtus ochrogaster. Science 187,1211-1213. 

Postpartum administration Postpartum administration in non-nursing mothers may begin at the first postpartum examination (4 to 6 weeks), regardless of whether spontaneous menstruation has occurred. Also, start no earlier than 4 to 6 weeks after a midtrimester pregnancy termination. 

Pregnancy term/naf/on- Misoprostol has been used in combination with mifepristone for pregnancy termination. Patients taking mifepristone must take 400 meg misoprostol orally 2 days after taking mifepristone unless a complete abortion has already been confirmed before that time. 

Koren G, Pastuszak A Prevention of unnecessary pregnancy terminations by counseling women on drug, chemical, and radiation exposure during the first trimester. Teratology 1990 41 657. [PMID 2353314]... 

Oxytocic for pregnancy termination Dinoprostone Prostin E2 Cocoa butter, triglycerides of fatty acids... 

Tripathy SN. Uterine rupture following intramuscular injection of carboprost in midtrimester pregnancy termination. J Indian Med Assoc 1985 83(9) 328. 

Seizures have been described during pregnancy termination induced by sulprostone (7). 

Bagga R, Chaudhary N, Kalra J. Rupture in an unscarred uterus during second trimester pregnancy termination with mifepristone and misoprostol. Int J Gynecol Obstet 2004 87 42-3. 

Hypoglycemia can also be induced by concomitant diseases, for example renal disease, hepatic disease (cirrhosis), hypopituitarism, hypoadrenocorticalism, hypoglucagonism, hypothyroidism, malnutrition, anorexia nervosa, pregnancy, termination of pregnancy, recovery from infections, operations, or stress. 

Dubin NH, Parmley TH, Cox RT, et al. 1981. Effect of silver nitrate on pregnancy termination in cynomolgus monkeys. Fertil Steril 36 106-109. 

Trade names Cervidel (Forest) Cerviprime Cerviprost KP-E Miniprostin E(2) Prandin E2 Prepidil (Pfizer) Primiprost Propess Prostarmon Prostin Prostin E2 Prostin VR Prostine Indications Pregnancy termination, uterine content evacuation, cervical ripening Category Prostaglandin Half-life 2.5-5.0 minutes... 

Mifepristone remains the gold standard since it has been in clinical use as single doses for pregnancy termination for almost a quarter of a century and considerable experience has been accumulated. Nevertheless very few long-term, randomized placebo-controlled studies have been reported. PAs and SPRMs which are undergoing clinical trials are shown in Table 7.1. 

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