Easy sonographic differential diagnosis between intrauterine pregnancy and cesarean delivery scar pregnancy in the early first trimester.

Background: Cesarean scar pregnancy (CSP) is a serious complication of pregnancy, which consists of implantation of the gestational sac in the hysterotomy scar. This condition is increasing in frequency and often poses a diagnostic challenge. Its diagnosis is dependent on visual assessment of the uterus on the longitudinal sagittal ultrasound plane.

Evaluation and management of postpartum hemorrhage: consensus from an international expert panel.

Background: Postpartum hemorrhage (PPH) remains one of the leading causes of maternal morbidity and mortality worldwide, although the lack of a precise definition precludes accurate data of the absolute prevalence of PPH.

Study Design And Methods: An international expert panel in obstetrics, gynecology, hematology, transfusion, and anesthesiology undertook a comprehensive review of the literature. At a meeting in November 2011, the panel agreed on a definition of severe PPH that would identify those women who were at a high risk of adverse clinical outcomes.

Mifepristone vaginally in an early medical abortion regimen: a pilot study.

Objective: This prospective observational pilot study was undertaken to assess the efficacy of mifepristone and misoprostol, both administered vaginally. The ultimate goal is to investigate alternative means of reducing the time interval between the two treatments involved. The efficacy of the early medical abortion regimen utilizing mifepristone and misoprostol is beyond doubt.

Vaginal azithromycin and misoprostol before surgical abortion.

Vaginally administered oral azithromycin tablets and specially formulated azithromycin and misoprostol vaginal pessaries achieved tissue levels significantly higher than those required to treat chlamydial infection.

Oral, rectal, and vaginal pharmacokinetics of misoprostol.

Objective: To compare the pharmacokinetic profiles of orally, rectally, and vaginally administered misoprostol tablets in pregnant women.

Methods: Women between 7 and 14 completed weeks of gestation were recruited and randomly assigned to be given 400 microg misoprostol orally, rectally, or vaginally 3 hours before surgical termination of pregnancy. Blood samples were obtained at 0, 7.

Post-partum haemorrhage: definitions, medical and surgical management. A time for change.

Any woman who gives birth can have post-partum haemorrhage which may threaten her life. PPH is one of the leading causes of maternal mortality and an important cause for serious morbidity in the developing and developed world. We are at the threshold of major developments in its prevention and treatment due to changing ideas about its definition and medical and surgical management.

Prostaglandins in the prevention and management of postpartum haemorrhage.

Myometrial contractility is integral to the delivery of the placenta and the arrest of potential subsequent haemorrhage. The details of this physiological process are patchy but it is clear that there is an important hormonal contribution. Oxytocin, with or without ergometrine, has thus been widely used with a recognized beneficial treatment effect.

Pharmacokinetics and adverse-effect profile of rectally administered misoprostol in the third stage of labor.

Objective: To characterize the pharmacokinetics and adverse-effect profile of rectally administered misoprostol.

Methods: To assess absorption of rectally administered misoprostol, 20 women were randomized to receive misoprostol 600 microg by either oral or rectal administration after delivery. Blood samples were obtained at 0, 7.

Randomized trial in multiparous patients: investigating a single vs. two-dose regimen of intravaginal misoprostol for induction of labor.

Background: Multiparous patients have a higher risk of hyperstimulation and uterine rupture than nulliparous patients. The minimum possible dose of uterotonic drug should be used in induction of labor for multiparous patients to avoid excessive uterine activity, which could increase both maternal and fetal risks.

Methods: One hundred and four women were randomized to either a single dose of 50 micro g of intravaginal misoprostol in 24 h, or two consecutive doses of intravaginal 50 micro g misoprostol 6 h apart.

Dinoprostone versus misoprostol: a randomized study of nulliparous women undergoing induction of labor.

Background: The objectives of the study were to compare the efficacy and safety of intravaginal misoprostol and intravaginal dinoprostone for induction of labor and to quantify the clinical response to suspicious cardiotocographic (CTG) readings.

Methods: One hundred and ninety-one patients were randomized to receive either 50 micro g misoprostol initially then a further identical dose 6 h later or 2 mg dinoprostone initially followed by 1 mg 6 h later, over a period of 24 h. If not in labor after 24 h, then both arms of the study would thereafter receive dinoprostone alone as per hospital protocol.