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Biomedical subjects

W E Brenner

Publications and source records attributed to W E Brenner.

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

Intra-amniotic administration of 15(S)-15-methyl-prostaglandin F2alpha for the induction of midtrimester abortion.

To determine the practicability of administering 15(S)-15-methyl-prostaglandin F2alpha-tromethamine (15(S)-15-Me-PGF2alpha) intra-amniotically for the induction of midtrimester abortion, initially 2.5 mg. of 15(S)-15-Me-PGF2alpha was administered to 20 physically healthy gravid women, and was repeated after 24 hours in those patients who had not aborted. Within 24 hours, 65% aborted, and within 36 hours, 95% aborted. Although 67% experienced emesis, no serious complications occurred. This abortion rate is similar to that obtained with the recommended dose schedule of the dosage of prostaglandin F2alpha approved by the Food and Drug Administration and those reported with intra-amniotic administration of either hypertonic saline or urea when augmented with high, continuous, intravenous infusions of oxytocin. While the study intra-amniotic dose schedule appeared to be practicable, large, comparative studies will be necessary to determine the most satisfactory dose schedule and whether this method is more acceptable than other available methods.

Abortion, Induced↗
PubMed1976

The effect of meperidine analgesia on midtrimester abortions induced with intra-amniotic prostaglandin F2alpha.

To determine whether increased amounts of meperidine significantly affect the induction of abortion with intra-amniotic prostaglandin F2alpha, 42 midtrimester subjects were treated with an identical dose schedule of PFG2alpha and one of two dose schedules of meperidine. Although the group that received more mepridine reported severe pain less frequently, their mean and median induction-to-abortion times, cumulative abortion rate, uterine contractility, and complications were not significantly different from those of the group that received less meperidine.

Abortion, Induced↗
PubMed1976

A comparative study of intra-amniotic saline and two prostaglandin F2alpha dose schedules for midtrimester abortion.

The efficacy, side effects, and complications of two intra-amniotic PGF2alpha dose schedules and the unaugmented intra-amniotic instillation of saline are compared. All three methods resulted in satisfactory rates of abortion within a relatively short period of time and within clinically acceptable rates of complications. Each method has its advantages and disadvantages. Further large comparative studies were needed.

Abortion, Induced↗
PubMed1976

Practicability of ultrasonography for assessing fetal age and weight in early pregnancy.

This study was conducted to evaluate (1) the feasibility and accuracy of the B-Scan technique for measuring biparietal diameter (BPD) in utero, (2) the accuracy of the B-Scan technique for predicting fetal age and weight, and (3) parameters of fetal growth in pregnancies of less than 21 weeks's gestation. Forty-one subjects underwent diagnostic ultrasonography before induction of therapeutic abortion with Prostaglandin F2alpha. Following abortion, fetal crown-to-rump length (CRL), crown-to-heel (CHL), BPD, and fetal weight were measured directly. After 13 menstrual weeks' gestation the BPD could be accurately measured by ultrasound. The relationship of BPD to gestational age and fetal weight and the indices of fetal growth as measured by the CRL and CHL were established. It is concluded that ultrasound is a useful adjuvant to clinical assessment of fetal age and weight in patients form 13 to 21 menstrual weeks' gestation.

Body Height↗
PubMed1976

Laparoscopic sterilization with electrocautery, spring-loaded clips, and Silastic bands: technical problems and early complications.

Among 2283 patients, rates of technical failure, technical difficulty, and operative and early postoperative complications were evaluated for different methods of tubal occlusion at laparoscopy: electrocoagulation (980 cases), spring-loaded clip application (991 cases), and Silastic band application (312 cases). Rates of technical failure and technical difficulty at surgery were significantly higher (P less than 0.05) for the spring-loaded clip technique than for the electrocoagulation and Silastic band techniques. Mechanical and optical difficulties with the prototype spring clip applicator were the major sources of technical difficulties. Rates of operative (1.2%) and early postoperative (1.9%) complications were not significantly different for the three techniques of tubal occlusion. It is concluded that all three study techniques appear to be practical, and large, long-term, randomized, comparative studies to determine rates of failure and subsequent gynecologic problems are necessary to determine the best method of sterilization.

Electrocoagulation↗
PubMed1976

Evaluation of intramuscular 15(s)-15-methyl prostaglandin F2 alpha tromethamine salt for induction of abortion, medications to attenuate side effects, and intracervical laminaria tents.

Sixty gravidas 8 to 20 menstrual weeks' gestation were studied to evaluate (1) the efficacy of intramuscularly administered 15(S)-15-methyl prostaglandin F2alpha tromethamine (15(S)-Me-PGF2alpha) as an abortifacient; (2) the effectiveness of prochlorperazine and Lomotil for attenuation of vomiting and diarrhea; and (3) the practicability of augmenting this prostaglandin dose schedule with intracervical laminaria tents. Group I subjects received 250 mug of 15(S)-Me-PGF2alpha intramuscularly every 2 hours for the initial 24 hours and 500 mug for the next 24-hour period. Group II received the same dose schedule of prostaglandin and prearranged doses of prochlorperazine and Lomotil. Group III received the same dose schedule of prostaglandin after intracervical laminaria tents had been inserted, and prochlorperazine and Lomotil were administered by the prearranged dose schedule. It appears that (1) the 15(S)-Me-PGF2alpha was effective in inducing abortion; (2) a significant decrease in body temperature occurred; (3) the abortifacient effectiveness of this prostaglandin dose schedule was not altered by the regimen of prochlorperazine and Lomotil; (4) only diarrhea was significantly attenuated with the regimen of prochlorperazine and Lomotil; and (5) laminaria augmentation was not useful.

Abortion, Induced↗
PubMed1975

The current status of prostaglandins as abortifacients.

The present use and potential uses of prostaglandins as abortifacients are summarized. Pertinent history, chemistry, prostaglandins' possible role in physiologic and pathologic processes and pharmacologic actions are discussed. The results of natural prostaglandins and their analogues by systemic and intrauterine administration for the purposes of postcoital contraception, menstrual regulation, first- and second-trimester abortion, preoperative dilation of the cervix, and delivery of patients with death in utero are presented. The only approved method of induction of abortion with prostaglandins, prostaglandin F2alpha by the intra-amniotic route for the induction of midtrimester abortion, is evaluated and compared to other methods of midtrimester abortion. It was concluded that: (1) the present use of prostaglandins is an important addition to the obstetrician's armamentarium, (2) more effective and/or convenient methods that are useful in patients over a wider gestational age appear to have been defined, and (3) the routine use of prostaglandins for postcoital contraception, menstrual regulation, and first-trimester abortion will require the development of analogues that are more specific as to their abortifacient actions than the natural prostaglandins and/or the development of improved delivery systems.

Abortifacient Agents↗
PubMed1975

The efficacy and safety of intramuscularly administered 15(S) 15 methyl prostaglandin E2 methyl ester for induction of artificial abortion.

The practicability of an intramuscular dose schedule of 10 mug of 15(S) 15 methyl prostaglandin E2 methyl ester [15(S) Me PGE2] administered every 4 hours was evaluated in 42 subjects from 7 to 20 menstrual weeks' gestation. Half of the subjects served as controls (Group I) and half of the subjects (Group II) were treated with a medication regimen of prochlorperazine, acetylsalicylic acid, diphenoxylate hydrochloride, and atropine sulfate to evaluate the regimen's effects. Although the 15(S) Me PGE2 dose schedule appeared to be effective (74 per cent aborted in 24 hours and 95 per cent aborted within 48 hours in a mean time of 18.9 hours), Group I (control) subjects frequently had side effects: 62 per cent had emesis, 86 per cent had diarrhea, 76 per cent had shivering, and 76 per cent had fever (greater than 100 degrees F.). Fewer Group II (medicated) subjects had side effects: 43 per cent had emesis, 19 per cent had diarrhea, 52 per cent had shivering, and 43 per cent had fever. The medication regimen did not appear to interfere with the abortifacient or oxytocic effects of the 15(S) Me PGE2 dose schedule, since Group I and Group II subjects had similar cumulative abortion rates, mean abortion times, and uterine activity. Although this 15(S) Me PGE2 dose schedule is effective in first-trimester patients, it is probably less satisfactory than the conventional method of vacuum aspiration. While intramuscularly administered 15(S) Me PGE2 with medications to attenuate side effects may be practicable for inducing midtrimester abortion, especially between 12 and 16 weeks' gestation, large controlled comparative studies of the intramuscular 15(S) Me PGE2 method and other experimental and conventional methods will be necessary to determine the most satisfactory method of performing midtrimester abortions.

Abortion, Induced↗
PubMed1975

Reduction of cervical resistance by prostaglandin suppositories prior to dilatation for induced abortion.

Several recent reports citing increased rates of prematurity among women who have had induced first-trimester abortion suggest that forceful cervical dilatation may result in cervical incompetence in future pregnancy. There appear to be conflicting clinical impressions regarding the effectiveness on cervical softening and the reduction of cervical resistance produced by various prostaglandins. The development of the Electronic Force Monitor which is capable of precise measurement of the forces encountered in overcoming resistance during dilatation provided objective evidence with which to evaluate the effects of vaginally administered prostaglandin E2 and F2alpha suppositories. Suppositories were administered 3 hours prior to cervical dilatation, after which suction curettage was performed. Compared to the nonmedicated control group, patients receiving PGF2alpha suppositories exhibited greatly reduced cervical resistance, in some cases permitting direct introduction of the suction curette without need for any preliminary dilatation. Those patients receiving PGE2 suppositories showed an intermediate degree of cervical softening.

Abortion, Induced↗
PubMed1975

Menstrual regulation in the United States: a preliminary report.

The efficacy and safety of vacuum aspiration on an outpatient basis without anesthesia or cervical dilatation within 14 days of a missed menstrual period was evaluated in 1,009 women. Among those patients in whom pregnancy could be documented (54.8%), 4.2% were still pregnant after the procedure. Potentially serious complications were pelvic infection (0.4%), bleeding requiring a repeat curettage (0.3%), and prolonged bleeding (0.7%). For comfort, 26.7% received local anesthesia or analgesia. To allow selection of a higher proportion of pregnant patients, the probability of pregnancy was derived for patients with either a positive or negative pregnancy test at each length of amenorrhea. To determine the best vacuum pressure and source, and the cannula size and type at each duration of pregnancy, a more extensive (large, controlled, comparative) study is required.

Abortion, Induced↗
PubMed1975

Menstrual regulation in family planning services.

Menstrual regulation is a safe, effective, and economical method of fertility control. Its increased safety compared to first trimester abortion establishes menstrual regulation by vacuum aspiration for treatment of up to 14 days missed menstrual period as probably better medical practice than waiting to confirm the presence of a pregnancy. Because it is a postcontraceptive method, menstrual regulation has potential in family planning services both as a recruitment service and for the treatment of contraceptive failures. Its use as an only method of fertility control is being studied. The acceptance of this new family planning service will primarily depend on its availability, dissemination of information about the service, and the ability of women freely to avail themselves of the service without delay. Although long term effects of single and repeated use of menstrual regulation are not known, its immediate complications are few and it can be recommended as a useful addition to present fertility control methods in family planning programs.

Abortion, Induced↗