Local administration of prostaglandin E2 for cervical ripening and labor induction: the appropriate route and dose.

Background: Although there are many comparative studies concerning the local administration of prostaglandin E2 gel for cervical ripening and labor induction, the safety, efficacy and the appropriate route and dose of the gel are still debated.

Patients And Methods: One hundred and ten women with high-risk pregnancy and unripe cervix received prostaglandin E2 gel 1 mg intravaginally (n=35), 2 mg intravaginally (n=36) and 0.5 mg intracervically (n=39), maximally three times at 6-hour intervals for cervical ripening prior to labor induction.

Reasons for pregnancy termination: negligence or failure of contraception?

Background: The aim of the study was to analyze the reasons for the failure of contraception and the reasons for not using any contraception among women seeking a legal abortion on social grounds. The women were also asked about their knowledge of contraception methods, including postcoital contraception.

Methods: We interviewed 200 women applying for a legal abortion within the first trimester of pregnancy about contraception, the contraceptive methods used, and the possible reasons for failure of contraception.

Comparison of enoxaparin, a low-molecular-weight heparin, and unfractionated heparin, with or without dihydroergotamine, in abdominal hysterectomy.

The effects of administration of low-molecular-weight heparin (enoxaparin 20 mg) once a day, of unfractionated heparin (5000 IU twice a day, and of unfractionated heparin (2500 IU) plus dihydroergotamine (0.5 mg) twice a day were assessed in 100 patients undergoing abdominal hysterectomy. The test medications were given subcutaneously 2 hours before operation and for 3 days thereafter.

Pelvic lymph node metastases in cervical cancer: comparison of lymphography, inspection, radiography, and histologic examination of lymph nodes.

Lymphangiography is commonly performed in the pretreatment evaluation of patients with cervical carcinoma, but its value is controversial. The purpose of this report is to determine the reliability of lymphography in the indication of metastatic pelvic lymph nodes by comparing data from preoperative lymphangiography, inspection of lymph nodes during laparotomy, radiography of surgically removed lymph nodes, and postoperative histologic report. Twenty-one patients (mean age 51.

Invasive cervical carcinoma in patients aged 35 or younger.

There has been concern that invasive cervical carcinoma is more aggressive in young women. We studied retrospectively 36 patients who were less than 35 years old (mean age 30.8 years, range 22-35 years, SD 3.

Ultrasonography in extended placental retention and intra-uterine adhesions; a case report.

A case report of extended placental retention and subsequent intra-uterine adhesions is presented. Three months after a second trimester abortion, ultrasonography was used to confirm the diagnosis of placental retention and to guide emptying of the uterus when normal curettage had failed. Later ultrasonic guidance was also used in the application of an IUD for the treatment of intra-uterine adhesions.

Intra-uterine contraceptive devices (IUDs) in relation to uterine histology and microbiology.

Histological and microbiological examinations were made of 90 uteri taken in association with abdominal hysterectomy. Thirty-one women had an intra-uterine contraceptive device (IUD) in utero at the time of operation, 16 women had previously used an IUD, while 43 had never used one. A chronic inflammatory reaction was seen significantly more often in the fallopian tubes of women with an IUD in situ (21/31, 68%) than in those who had never used an IUD (7/43, 16%).

Wertheim radical hysterectomy. Surgical complications, accuracy of clinical staging and value of lymphangiography in cervical carcinoma.

Wertheim radical hysterectomy combined with pelvic lymphadenectomy was performed at the Helsinki University Central Hospital on 132 women of whom 120 had cervical carcinoma from Stage IA to early IIB and 12 had endometrial carcinoma Stage II. None of the patients died or had severe complications during their hospitalisation. The left ureter was accidently transected in two patients and both were corrected immediately.

Diflunisal compared with naproxen in the treatment of dysmenorrhea.

A randomized double-blind cross-over study was carried out in 19 young female undergraduates with severe primary dysmenorrhea to compare the efficacy and tolerance of treatment with diflunisal and naproxen. All patients received both substances twice during four consecutive cycles. The first tablet was taken at the onset of dysmenorrheic symptoms and continued according to the individual need, maximally four tablets daily.

A Gemeprost vaginal suppository for cervical priming prior to termination of first trimester pregnancy.

A randomized, double-blind, placebo-controlled, multicentre study was conducted to assess the efficacy and tolerance of a single 1.0 mg Gemeprost (16, 16-dimethyl-trans-delta 2PGE1 methyl ester) vaginal suppository for dilatation of the cervix uteri prior to vacuum aspiration termination of first trimester pregnancy in nulliparous women. The suppository was inserted three hours before vacuum aspiration.

Maternal half-sitting position in the second stage of labor.

The maternal half-sitting and supine position during the second stage of fullterm labor was compared in 100 women who, after identical opening phases in supine position, randomly delivered in half-sitting (50 degrees, n = 50) or supine position (n = 50). The whole duration of the second stage of labor or the time spent in active pushing did not differ between the groups. Vacuum extraction was needed twice (4%) in the group delivering in half-sitting and six times (12%) in the group delivering in supine position.

Radiographic findings in cervix uteri after prostaglandin abortion induction.

Hysterography was performed on 173 nulliparous patients following termination of midtrimester pregnancy by intra-amniotic prostaglandin F2 alpha (PGF2 alpha). In 21 hysterograms (12%) a pathologically wide internal os was found, compared with three out of one hundred routine hysterograms carried out for infertility examination. A deformed cervical canal with filling defects and synechiae was found in the hysterograms of 28 patients (16%).

Effect of sulprostone on concentrations of progesterone, 20 alpha-dihydroprogesterone, estrone, and estradiol in human placental tissue in the first trimester of pregnancy.

Placentas were obtained from 35 healthy women whose pregnancy was terminated in the first trimester. Seventeen of them had no prostaglandin medication whereas in 18 women 500 micrograms of sulprostone was administered for cervical softening 12-14 h prior to the termination of pregnancy. Concentrations of progesterone and 20 alpha-dihydroprogesterone were determined from the extract of the placenta by liquid chromatography and those of estrone and estradiol by a radioimmunoassay.

Prevention of venous thrombosis by dipyridamole-naproxen and low-dose heparin in patients undergoing hysterectomy.

Orally administered dipyridamole in combination with naproxen was compared with subcutaneously administered low-dose heparin in prevention of deep venous thrombosis after abdominal hysterectomy. The radioactive fibrinogen test was used to diagnose thrombosis. Only one patient in the total series of 65 developed thrombosis.

Susceptibility of abortion patients to infection: Correlation to cervical flora.

Cervical bacterial microflora was studied with a semiquantitative method in 29 women both before and after the termination of their pregnancy. The main findings were high prevalence of anaerobic bacteria (in 72%-79% of the specimens) consisting predominantly of Bacteroides species and anaerobic Gram-positive cocci, and low prevalence of aerobic bacteria (in 24%-38% of the specimens). Among the other microbes studied, the prevalence of Chlamydia excretors was high (24%), probably reflecting a promiscuous study population.

Abortion with sulprostone, a prostaglandin E2 derivative.

Sulprostone, a prostaglandin E2 derivative, was used in a multicenter trial to terminate 478 pregnancies of 8-21 weeks' gestation. The compound was clinically well accepted without premedication in extraovular, intravenous and intramuscular routes of administration. At 24 hours after treatment, 67%-88% of the patients had aborted, with a low average incidence of side effects.