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Biomedical subjects

B Maria

Publications and source records attributed to B Maria.

At least 37 records · Page 2Linked to original sources
PubMed1995

Effects of gemeprost and mifepristone on the mechanical properties of the cervix prior to first trimester termination of pregnancy.

OBJECTIVE: To study the effects of oral mifepristone and vaginal gemeprost on the mechanical properties of the cervix prior to first trimester termination of pregnancy by vacuum aspiration. DESIGN: A comparative study. Each patient served as her own control. SETTING: The Royal Infirmary of Edinburgh, Scotland, UK. SUBJECTS: Forty nulliparous women at six to twelve weeks of pregnancy. INTERVENTIONS: The women received either gemeprost (1 mg) 3 h prior to termination of pregnancy or mifepristone (200 mg) 48 h before operation. MAIN OUTCOME MEASURES: Two different objective methods of assessment of the mechanical properties of the cervix, one measuring the distensibility of the cervix before drug administration and immediately before the operation, and the other measuring the force necessary to dilate the cervix; incidence of new symptoms following drug intake; immediate complications and estimated blood loss. RESULTS: Both treatments significantly increased cervical distensibility. Baseline dilatation was greater in the mifepristone group. The force required to dilate the cervix was significantly reduced in mifepristone-treated patients. There was a good correlation between the two different methods of assessment of the mechanical properties of the cervix only in the gemeprost group. CONCLUSION: Cervagem and mifepristone can be used to increase cervical distensibility. Cervical dilatation is easier with a 48 h regimen of mifepristone than with gemeprost.

Abortifacient Agents, Nonsteroidal↗
PubMed1994

[Methods of second trimester pregnancy termination and evacuation of in utero dead fetuses. Value of mifepristone].

The authors present a review of the literature on the current methods of second trimester termination of pregnancy and labour induction for fetal death. Prostaglandins are efficient, but may cause side-effects (nausea, vomiting) and painful contractions. Natural PGs (PGF2 alpha and PGE2), induce fetal expulsion in about 80% of cases within 24 h. PG analogues (sulprostone and gemeprost), are, presently, more used, and lead to fetal expulsion in 90% of cases, with less side-effects. Mifepristone, an antiprogesterone steroid, increases uterine activity, sensitizes myometrium to PG action, and induces cervical priming. Several clinical trials point out the advantage of mifepristone use, 24 to 48 h before PG. So, the duration of termination, and the PG dosage are reduced by half. A clinical protocol for second trimester termination, with mifepristone, and PG analogues, is proposed. In case of fetal death, labour induction is now accepted. The expulsion of a dead fetus is easier than a live one. PG and analogues show a good efficacy: > 90% success within 24 h. Mifepristone, alone, leads to fetal expulsion in 2/3 of cases, within 72 h, without side-effects. A clinical protocol of induction with mifepristone and PG in case of fetal death is proposed. In these two difficult clinical cases, mifepristone is of great interest, in reducing duration of termination, and increasing comfort and security for the patients.

Abortion, Induced↗
PubMed1992

[Prevalence of hepatitis C virus antibodies (tests ELISA 2 and RIBA 2) in a population of pregnant women in France].

We studied the prevalence of anti-HCV antibodies in a population of 2,367 pregnant women attending three public Parisian suburban hospitals. Of this group, 1,614 (68 percent) were French and 753 (32 percent) were immigrant women. The geographic origin of the immigrant population was North Africa (40 percent), West Africa (33 percent), Asia (14 percent), and South Europe (13 percent). Anti-HCV antibodies were tested by the Ortho ELISA second generation test. If present, the Ortho's four-antigen RIBA test and serum alanine aminotransferase determinations were done routinely. The overall prevalence was 1.73 percent. It was 1.55 percent in French women and 2.13 percent in immigrant women. Risk factors associated with anti-HCV were found in 68 percent of the anti-HCV positive French women and in 44 percent of the positive immigrant women. Risk factors were significantly more frequent in anti-HCV positive women in both groups. Among the 41 women with a positive ELISA test, 16/25 French women (64 percent) and 8/16 immigrants (50 percent) had a positive four-antigen RIBA test. Thus, the prevalence of a positive RIBA test was similar in both groups (0.99 and 1.06 percent), due to a higher proportion of false positive ELISA tests observed in the immigrants. These results show that, in French pregnant women: a) the prevalence of anti-HCV is twice as high as that found in blood donors and is a better estimation of the actual prevalence of these antibodies in France; b) positive ELISA 2 tests are most often confirmed by a positive RIBA 2 test.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Predictive value of the active renin assay for the diagnosis of ectopic pregnancy.

The increasing frequency of EP and the need for its early diagnosis have focused our interest on the research of biochemical markers. We have established hormonal values in the plasma of 99 spontaneous ongoing pregnancies between the 4th and 10th weeks of amenorrhea, in 21 EPs, and 20 cases of early abortion. We have examined the predictive values of trophoblastic and CL production in pathological pregnancies. The association of low hCG and low active renin appears to be able to discriminate between ectopic and abortive spontaneous gestations.

Abortion, Spontaneous↗
PubMed1990

Induction of labor with mifepristone (RU 486) in intrauterine fetal death.

In a double-blind controlled multicentric study involving 94 patients with an intrauterine fetal death, we investigated the efficacy and tolerance of mifepristone (RU 486), a steroid compound that antagonizes progesterone action at the receptor level. Success of treatment was defined as the occurrence of fetal expulsion within 72 hours after the first drug intake. Mifepristone treatment (600 mg per day for 2 days) was considered to be effective in 29 of 46 patients (63%). There were only eight successes in 48 patients (17.4%) in the placebo group (p = 0.001, chi 2 test). Tolerance was good in the mifepristone group. In the placebo group, disseminated intravascular coagulation occurred in one woman for whom the investigator waited several weeks for spontaneous expulsion. This large double-blind controlled study provides evidence that mifepristone is of interest in the management of intrauterine fetal death. It could provide a pharmacologic alternative to the use of prostaglandins in this indication.

Adult↗
PubMed1990

Termination of early pregnancy through a combination of the antiprogestin and prostaglandin analogue.

Termination of early pregnancy (less than 49 days of amenorrhea) was induced in 75 patients with the combination of the antigestagen mifepristone and a prostaglandin analogue, meteneprost. After 48 h a single oral dose of 600 mg of mifepristone was followed by a 10 mg meteneprost vaginal pessary. Pregnancy was confirmed by clinical and ultrasound examinations and plasma HCG assessment. Complete abortion occurred in 72 patients (96%) and the three others required a surgical uterine aspiration. Bleeding continued for 4 to 12 days (mean = 8). Uterine pain and side effects occurred during the 3 h following the use of prostaglandin. Only minor analgesic were required in 30 patients. The combination of mifepristone and meteneprost is a safe and effective method to terminate an early pregnancy.

16,16-Dimethylprostaglandin E2↗
PubMed1990

[Antiprogesterone, prostaglandin analogues and the early interruption of pregnancy].

Early termination of pregnancy, or menstrual regulation, is recommended for use within 7 weeks of amenorrhea, ie 49 days. Aspiration is a widely used method, with a failure rate of 2 to 5 p. cent and a complication rate of 4 p. cent. But, aspiration need experienced practitioners. Prostaglandins may be used with efficacy. New analogues (sulprostone, meteneprost, gemeprost) are studied. The success rate is over 90 p. cent, but severe uterine pains occurred in 50 p. cent of cases, as gastro-intestinal side effects. Mifepristone is an antiprogesterone steroid which is able to terminate early pregnancy with a success rate of 80 p. cent and very few side effects. The combination of mifepristone and a low dose of a prostaglandin-analogue is a very well tolerated procedure with a success rate of 95 p. cent. It seems to be a good alternative to early aspiration.

Abortifacient Agents↗
PubMed1990

[The diagnosis of a pseudo-unicornous uterus. Apropos of a pregnancy in a rudimentary uterine horn].

The following is a report of an unusual case of a patient who had a rupture of the rudimentary horn at 21 weeks of pregnancy. Hysterography had shown that she had a unicornuate uterus but she had not had a laparoscopy. Later ultrasound pictures at the beginning of pregnancy failed to reveal that the pregnancy sac was ectopic. The authors also stress the absolute need to carry out laparoscopy in cases of unilateral Müllerian hypoplasia. They show how to read ultrasounds in cases of pregnancies in rudimentary horns. They try to point out the best procedures for diagnosis using the literature.

Adult↗
PubMed1989

Termination of early pregnancy using mifepristone in combination with prostaglandin analogs.

Mifepristone, (RU 486), is an antiprogesterone which, when administered alone will terminate early pregnancy in 80% of cases. Prostaglandins at high doses have also been used to terminate pregnancy but there are often unacceptable side effects. The combined treatment of mifepristone with low doses of prostaglandin analogs appears to be an effective method for termination of pregnancy, with a high success rate and a reduction in the side effects observed with prostaglandins.

16,16-Dimethylprostaglandin E2↗
PubMed1988

Termination of early pregnancy by a single dose of mifepristone (RU 486), a progesterone antagonist.

Mifepristone (RU 486) is a new steroid which is a progesterone antagonist and which is able to interrupt early pregnancy without any major side-effects. The purpose of our study was to evaluate the clinical effect of a single oral dose of 600 mg on early pregnancy. The study included 150 healthy women applying for a legal abortion with an amenorrhea of no more than 42 days. Pregnancy was confirmed by clinical and ultrasound examination and plasma HCG assessment. Success was assumed by repeating these exams on the eighth day. 131 patients had a complete abortion (87.3%), with a very few side-effects. Only two patients needed curettage for heavy bleeding. Mifepristone is able to terminate early pregnancy by an easy ambulatory method under medical supervision.

Abortifacient Agents↗
PubMed1988

[Early pregnancy interruption using an antiprogesterone steroid: Mifepristone (RU 486)].

Mifepristone (RU 486) is a new steroid which is a progesterone antagonist and which is able to interrupt early pregnancy. The purpose of our study was to evaluate clinical efficacy and tolerance of two doses of Mifepristone (600 and 200 mg) in a single intake. The study included 205 women applying for a legal abortion with pregnancies under 7 weeks. Clinical examination was confirmed by ultrasound and plasma HCG assessment. Success was assumed by repeating these exams on 8th day. 175 patients took 600 mg of Mifepristone and 147 (84%) had a complete abortion. 30 patients took 200 mg of mifepristone and only 19 (63%) had a complete abortion. Very few side effects were observed. So, Mifepristone in able to terminate early pregnancy under medical supervision.

Abortifacient Agents↗
PubMed1987

[Cervical dilatation by use of a vaginal suppository of meteneprost before voluntary interruption of the pregnancy in the first trimester].

Instrumental dilatation of the cervix prior to first trimester absorption may be difficult and source of complications. Pharmacological dilatation is proposed in a prospective random study using vaginal suppository containing 10 mg of 9-deoxo, 16-16 dimethyl, 9 methylene PGE2 (Meteneprost). Mean cervical dilatation, 3 hours after treatment, was significantly higher in the treated group (8.1 vs 6 mm) and additional dilatation was facilitated by cervical softening. Side effects occurred in most of the treated patients (uterine pain) but on a minor scale. This procedure may be considered as effective, safe and easy.

16,16-Dimethylprostaglandin E2↗
PubMed1983

[Maturation of the cervix uteri using prostaglandin F2 alpha before induction of labor in pathologic pregnancies].

It is possible to induce labour in pathological pregnancies after artificial ripening of the cervix. The present study concerns 70 patients (45 primipara, 25 multipara). The main pathologies are hypertension of pregnancy and pregnancies past dates. Prostaglandin F2 alpha has been used with a Tylose gel containing 5 mg of PGF2 alpha introduced by the extra-amniotic route. The cervical change was noted using Bishop's score. The mean increase of the cervical score was 0.8 with the first PGF2 alpha gel. The total mean increase was 1.2. Two cases of hyperstimulation of the uterus were observed and they led to Caesarean section. Prostaglandin gel induced labour in 56% of the patients. The mean time between the introduction of the gel and the delivery was 14 h for primipara and 10 h for multipara. Other patients were induced with oxytocin on the following day. Epidural analgesia was widely used in this study (in 64% of cases). The mean duration of labour was 6 h 10 for primipara and 4 h 30 for multipara. 30% of the patients needed Caesarean section but there was a marked difference between primipara (36%) and multipara (4%). After a review of the literature the authors conclude that it is useful to ripen the cervix prostaglandin but, as foreign authors do, they think that PGE2 should be more efficient.

Cervix Uteri↗
PubMed1983

[Therapeutic interruption of pregnancy in the second trimester after preparation of the cervix with prostaglandins F2 alpha].

The use of prostaglandins is one of the best techniques for second trimester abortion. The authors present 40 patients aborted by a new two stage technique: First: ripening of the cervix a tylose gel containing 5 or 10 mg PGF2 alpha every 12 hours during 3 days. Then, if abortion is not obtained, previously published techniques are used: intra-amniotic injection (40 mg PGF2 alpha) or intra-cervical infusion (2 mg/hour). The mean duration of these abortions is 52 hours using 29 mg of PGF2 alpha. 22 patients aborted during ripening (mean = 27 hours), 12 patients needed an intracervical infusion (mean = 88 hours) and 6, an intra-amniotic injection (mean = 72 hours). It seems that abortion is easier when pregnancy is earlier, under 20 weeks of gestation. Few side effects were observed: only three cases of fever with a single case of endometritis. Failure of this technique occurred in five patients (4 aborted outside the time allowed for, and one needed instrumental extraction). With this technique, the mean duration is longer than those previously described in the literature but the efficiency is over 90%.

Abortion, Therapeutic↗