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Biomedical subjects

M P Embrey

Publications and source records attributed to M P Embrey.

At least 37 records · Page 2Linked to original sources
PubMed1976

Extra-amniotic 15 (S)-15 methyl PGF2alpha to induce abortion: a study of three administration schedules.

Abortion was induced in 60 patients between 8 and 18 weeks gestation using 15(S)-15 methyl PGF2alpha in one of three extra-amniotic administration schedules: 1.0 mg in viscous medium (Tylose), 1 mg in viscous medium (Hyskon) or 0.5 mg in non-viscous medium repeated at 12 hours. Eighty per cent of patients aborted within 24 hours in each group. The overall mean induction-abortion interval (+/- S.E.) was 17.6 +/- 2.0: there was no significant difference between the three groups. Twenty patients treated with 1.0 mg in viscous medium had the catheter removed immediately following the prostaglandin injection and the success rate was not significantly altered. Gastro-intestinal side effects (vomiting in 50%, diarrhoea in 32.5%) were more frequent in the patients treated with the larger dose though the difference was not statistically significant. No significant haematological or biochemical changes were detected during the 24 hours following the start of treatment in 24 patients investigated. Thirty seven of the 60 patients (61.5%) aborted completely and did not require surgical evacuation, and none lost more than 500 ml of blood, nor required transfusion. It is concluded that abortion can be induced with a single extra-amniotic injection of 1 mg of 15(S)-15 methyl PGF2alpha in viscous medium in a large percentage of patients but that the incidence of side effects is high.

Abortion, Induced↗
PubMed1976

Single extra-amniotic injection of prostaglandins in viscous gel to induce abortion.

A single extra-amniotic injection of prostaglandin (PG) E2 or F2alpha in a highly viscous gel was administered to 230 patients to induce abortion between 9 and 24 weeks gestation. PGE2 doses of 1-0, 1-5, 2-0 or 3-0 mg induced abortion within 24 hours in 30 per cent, 75 per cent, 76 per cent and 70 per cent of patients respectively. The incidence of gastrointestinal side-effects was dose dependent, being 20 per cent, 35 per cent, 45 per cent and 70 per cent in the respective groups. A 10-0 Pmg dose of PGF2alpha induced abortion within 24 hours in 66 per cent of patients and 45 per cent had gastrointestinal side-effects. Abortion was more often complete with PGE2 (76 per cent) than with PGF2alpha (36 per cent). Immediate withdrawal of the catheter following PG administration did not influence induction-abortion intervals or 24-hour abortion success rates. This technique significantly reduced individual patient care and minimized the potential risk of intrauterine sepsis associated with extra-amniotic techniques requiring repeated or continuous PG administration.

Abortion, Induced↗
PubMed1976

Intrauterine (extraamniotic) prostaglandins in the management of unsuccessful pregnancy.

Extraamniotic administration of prostaglandin E2 or prostaglandin F2alpha has been used in the treatment of 72 cases of unsuccessful pregnancy which included 50 of fetal death in utero, 13 of anencephaly and nine of hydatidiform mole. This management is highly effective in achieving abortion or delivery within 24 hours in almost all cases and results in few side effects. Pyrexia occurred during treatment in three patients, but in none was intrauterine infection observed. Blood loss greater than 250 ml occurred in only two patients, and none required transfusion. We advocate the use of extraamniotic prostaglandins as an active approach to the problem of unsuccessful pregnancy to relieve the patient of emotional distress and avoid the hazards of blood coagulopathy and intrauterine infection, both of which increase the longer a dead fetus is retained in utero.

Abortifacient Agents↗
PubMed1976

Intrauterine prostaglandin E2 as an postconceptional abortifacient.

1. Thirty-eight pregnant women, 2 to 33 days overdue with a menstrual period, were treated with a single intrauterine injection of PGE2. 2. Abortion occurred in 7 of 12 patients (58.3%) treated with PGE2 100 mug and in 22 of 26 patients (84.6%) given PGE2 500 mug. 3. The only side effect was uterine pain requiring analgesia in four of the former and 15 of the latter. Four patients required curettage to control bleeding.

Abortifacient Agents↗
PubMed1975

Single extra-amniotic injection of prostaglandin E2 in viscous gel to induce mid-trimester abortion.

In a preliminary study a single extra-amniotic injection of 1.5 mg of prostaglandin E-2 incorporated into an aqueous viscous gel was given to 24 patients aborted within 24 hours, and the mean induction-abortion interval (plus or minus S.E. of mean) was 13.5 plus or minus 1.5 hours. Vomiting occurred in seven patients, and transient severe uterine cramps, pallor, nausea, and shivering occurred in one patient immediately after injection. Complete abortion occurred in 20patients. A delay in the time taken to abort seemed to be associated with an immediate and rapid rise in uterine tone after the injection which required prompt analgesia; this probably reflected rapid decidual absorption and dissolution of the prostaglandins away from their site of action. The degree of distention of the catheter-retaining balloon did not influence abortion times.

Abortion, Induced↗
PubMed1975

Comparison of intravenous oxytocin and prostaglandin E2 for induction of labour using automatic and non-automatic infusion techniques.

A double blind trial of prostaglandin E2 and oxytocin given by intravenous infusion after amniotomy for induction of labour in 100 primigravidae with unfavourable induction features is reported. No clear-cut advantage of either drug emerged although PGE2 was perhaps superior when the cervix was highly unfavourable. Prostaglandin E2 appeared to produce less deleterious effects on the fetus but was associated with a higher incidence of maternal side effects. The automatic Cardiff Infusion apparatus was found to be a safe means of PGE2 infusion and to have advantages over the use of non-automatic techniques both for PGE2 and for oxytocin infusion.

Adolescent↗
PubMed1974

Prostaglandin-induced abortion: assessment of operative complications and early morbidity.

A total of 626 patients undergoing a prostaglandin-induced abortion, the majority in the second trimester, have been analysed for complications occurring during inpatient treatment. Of the last 155 consecutive patients 143 were critically assessed six to eight weeks after abortion for morbidity occurring during their early recovery period.Blood loss of 250 ml or more occurred in 68 patients, pyrexia in 34, pelvic infection in three, and readmission in 14 of the 626 patients studied, and a transfusion was required in eight.Bleeding after abortion stopped within six weeks in all 143 of the 155 consecutive patients assessed but three required readmission for uterine curettage. Menstruation was re-established within six weeks of abortion in 106 patients.The incidence of operative morbidity was similar to that reported for first trimester abortion and better than that in most reported series of second trimester abortions.

Abortion, Induced↗
PubMed1973

Blood coagulation changes during mid-trimester abortion induced by prostaglandin F2 alpha.

Serial studies on the coagulation system were made during second-trimester abortion induced by extra-amniotic, intra-amniotic, vaginal, and intravenous prostaglandin F(2)alpha. No significant changes were found in the prothrombin time, partial thromboplastin time, or levels of fibrin-fibrinogen degradation products. An increase in the activity of factor X occurred with all routes of administration; the activity of factor VIII increased during extra-amniotic, vaginal, and intravenous administration; factor V activity increased during extra-amniotic and vaginal administration; and the activity of factor VII-X complex increased slightly at the time of abortion with all methods.The findings suggest that though prostaglandin induction of second-trimester abortion produces changes in the coagulation system the effects are much less than those which accompany induction of abortion by hypertonic saline or abdominal delivery in late pregnancy.

Abortion, Induced↗
PubMed1973

Coagulation changes during termination of pregnancy by prostaglandins and by vacuum aspiration.

Serial studies on coagulation factors were performed on 12 patients having termination of mid-trimester pregnancy by extra-amniotic prostaglandin F(2)alpha and 11 patients terminated by vacuum aspiration during the first trimester. A significant change in the activity of factors V, VII and X, VIII, and X, and a decrease of the prothrombin time and platelet count were found with prostaglandin termination but no such changes occurred during vacuum aspiration. These findings suggest that the coagulation system is activated during induction of mid-trimester abortion with extra-amniotic prostaglandin F(2)alpha. This is probably related to the physiological changes in the coagulation mechanism which occur by the second trimester of pregnancy. Termination of pregnancy in the mid-trimester may, however, be expected to give rise to defective blood coagulation and thromboembolic complications.

Abortion, Induced↗