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Biomedical subjects

M Bygdeman

Publications and source records attributed to M Bygdeman.

At least 181 records · Page 10Linked to original sources
PubMed1979

Acceptability of a nonsurgical method to terminate very early pregnancy in comparison to vacuum aspiration.

Seventy-seven patients applying for abortion during early pregnancy consented to be treated by prostaglandin vaginal suppositories or vacuum aspiration by Kahrman catheter in a random design. They also consented to participate in an acceptability study of the two procedures. Attitude and preference measures were obtained by interviewing and rating scales on three occasions: before assignment to abortion procedure, immediately after treatment, and two weeks later. The first 30 patients with complete abortion by either procedure participated in the acceptability study. Both treatments were positively evaluated but perceived to have very different characteristics. The preference for the method used for own treatment increased in both groups. Before treatment 1/3 of the patients in each group had a positive attitude to a self-administered method to induce abortion outside clinics. This proportion increased significantly after treatment but only in the group that received prostaglandin by the vaginal route.

Abortion, Induced↗
PubMed1979

Treatment with a single vaginal suppository containing 15-methyl PGF2 alpha methyl ester at expected time of menstruation.

Termination of early pregnancy, by vaginal administration of prostaglandin analogues, one to three weeks after the first missed menstrual period, has advantages and disadvantages in comparison with vacuum aspiration. Some of these may be reduced if the patient is treated earlier. In the present study the effect and safety of one vaginal administration of 2.5 to 3 mg 15-methyl-PGF2 alpha methyl ester around the expected time of menstruation was evaluated in 16 women exposed to the risk of pregnancy. The overall number of treatment cycles was 35 and pregnancy was confirmed by plasma beta-HCG in eight. The treatment resulted in bleeding in all the pregnant cycles while in the nonpregnant ones it only provoked spotting and bleeding did not begin until the expected time of menstruation. Treatment with 2.5 mg 15-methyl-PGF2 alpha methyl ester resulted in complete abortion in one of three women. If the dose was increased to 3 mg all five treated women aborted. In nonpregnant patients no changes in the levels of estradiol-17 beta or progesterone at any time during the 24-hour observation period were found. Serum cortisol and prolactin but not TSH levels started to increase two hours after the start of treatment and reached a maximum after five hours. The increase coincided with the onset of uterine pain. Ovulatory cycles as judged from basal body temperature occurred in the first menstrual cycle following treatment in all nonpregnant patients. Although possible to use as a "once a month treatment" it seems preferable since the dose is the same, to postpone treatment until menstruation is delayed for a week or more.

Abortion, Induced↗
PubMed1979

Effects of the prostaglandins on the uterus. Prostaglandins and uterine contractility.

The effect of intravenous and intrauterine administration of PGE1 or PGE2 and PGF2 alpha as well as oral administration of PGE2 on the sensitivity and reactivity of the nonpregnant human uterus was studied. With the use of the flaccid microballoon technique or a micro transducer catheter, uterine recordings were made at frequent intervals throughout the menstrual cycle. Independently of the route of administration and of the phase of the cycle, treatment with PGF2 alpha invariably resulted in stimulation of uterine motility. A high sensitivity to PGF2 alpha was noted during the late secretory phase both in normal and dysmenorrheic women. A marked decrease in sensitivity to both PGE2 and PGF2 alpha administered by the intrauterine route was observed in the periovulatory phase. Inhibition of uterine contractility by PGE2 following both intrauterine and oral administration was noted during active menstrual bleeding in normal as well as in dysmenorrheic women. These findings suggest that endogenous prostaglandins may play a role in the regulation of the normal uterine motility during the menstrual cycle and that the main reason for the abnormal contractility pattern seen in dysmenorrheic women during menstrual bleeding is an increased PGF2 alpha/PGE2 ratio.

Administration, Oral↗
PubMed1978

The influence of locally administered prostaglandin E2 and F2alpha on uterine motility in the intact non-pregnant human uterus.

Clinical studies on the effect of locally administered prostaglandin E2 and F2alpha on the sensitivity and reactivity of the non-pregnant human uterus were performed in 16 volunteers. With the use of the flaccid microballoon technique, uterine recordings were made at frequent intervals throughout the menstrual cycle. As little as 0.25 microgram PGF2 or 1.0 microgram PGF2alpha effected an increase in uterine motility during most of the proliferative and secretory phases of the menstrual cycle. However, a marked decrease in sensitivity and suppression of reactivity to either prostaglandin compound was observed around ovulation. Moreover, an inhibition of uterine contractility in response to PGE2 but not to PGF2alpha was noted during active menstrual bleeding. Circulating levels of estrogen could be correlated generally with these uterine responses. Endogenous prostaglandins normally occur in the secretory endometrium in levels compatible with the amount of exogenously administered prostaglandins which elicited increased, decreased, or unchanged uterine activity in this study. These findings suggest that local prostaglandin E2 and F2alpha in concert with variable levels of circulating estrogen, may play important roles in the cyclic regulation of uterine motility during the menstrual cycle.

Estrogens↗
PubMed1978

Comparison of prostaglandin and hypertonic saline for termination of pregnancy.

The abortifacient efficacy and complication rate of the administration of hypertonic saline intraamniotically to 796 women were compared with those following administration of various prostaglandins by several routes to 3783 women. Intraamniotic administration of 2.5 mg 15-methyl-PGF2alpha or repeated vaginal administration of 15-methyl PGF2alpha methyl ester were both highly effective. The interval from treatment to abortion following prostaglandin administration was significantly shorter than that following hypertonic saline. The frequency of complications varied with prostaglandin compound and route of administration but was generally of the same magnitude as that following hypertonic saline administration. None of the prostaglandin-treated patients experienced epileptic seizures, and no maternal deaths occurred.

Abortion, Induced↗
PubMed1977

Preoperative dilatation of the cervix by single vaginal administration of 15-methyl-PGF2alpha-methyl ester.

Two different vaginal suppositories have been developed suitable for one single treatment for preoperative dilatation of the cervix prior to vacuum aspiration in late first trimester abortion. The study included 60 patients equally distributed in one control group (Group I) where vacuum aspiration was performed without pretreatment; one group (Group II) where the patients obtained 2.0 mg 15-methyl-PGF2alpha-methyl ester in a rapid releasing base six hours prior to operation and one group (Group III) where the prostaglandin dose was increased to 2.5 mg 15-methyl-PGF2alpha-methyl ester and a more slow releasing base was used and the operation performed after 12 hours. The mean cervical dilatation at operation was in Group II 9 mm and in Group III 11 mm in comparison with 4.8 mm in the control group. The bleeding at the operation was also significantly reduced.

Abortion, Induced↗
PubMed1977

Plasma levels of 15(S)15-methyl PGF2alpha following administration via various routes for induction of abortion.

Plasma levels of 15(S)15-methyl PGF2alpha were measured by gas chromatography - mass spectrometry following intravenous, intramuscular and subcutaneous administration. During intravenous infusion of 1.0 and 2.5 microgram/min of the drug for six hours the plasma levels were relatively constant around 600 and 1200 picog/ml, respectively. At an infusion rate of 5 microgram/min the plasma level continuously increased during the administration. Intramuscular injections of 100-400 microgram of 15(S)15-methyl PGF2alpha gave maximum levels in plasma (700-1700 picog/ml) after 15-20 minutes followed by a gradual decrease during more than three hours. This rapid resorption of drug into plasma could be delayed by addition of 5 microgram epinephrine to the injected solution. Analyses during a series of intramuscular injections demonstrated that a therapeutical plasma level could be maintained by injections at two to three hour intervals.

Abortion, Induced↗
PubMed1976

Outpatient postconceptional fertility control with vaginally administered 15(S) 15-methyl-PGF2alpha-methyl ester.

15(S) 15-methyl-PGF2alpha-methyl ester was administered as vaginal suppositories to terminate very early gestation in 16 outpatients who were thought to be pregnant. All patients received between 2.5 and 5.0 mg. of the prostaglandin compound. Pregnancy was confirmed later in 10 of the women. In these patients vaginal bleeding started 3 to 6 hours after the start of therapy and continued for an average of 8 days. By subjective assessment, the amount of bleeding during this time was equal to or slightly heavier than that of a normal menstruation for each woman. Patients were followed for 2 to 4 weeks with serial measurements of serum progesterone and HCG. There were no failures at early pregnancy interruption. Gastrointestinal side effects rarely were encountered; no serious complications occurred and no curettage had to be performed because of heavy bleeding. The vaginal use of the methyl ester of 15(S) 15-methyl-PGF2alpha for the termination of early pregnancy seems promising as a reliable and parctical outpatient procedure.

Abortifacient Agents↗