1.  Peer Reviewed Title: An historical overview of second trimester abortion methods. Author: Bygdeman M; Gemzell-Danielsson K Source: Reproductive Health Matters. 2008 May;16(31 Suppl):196-204. Abstract: The methods used for abortion in the second trimester have changed considerably in recent years. The surgical procedure dilatation and evacuation (D&E) has replaced hysterotomy. Instead of injecting different compounds, such as hypertonic saline, prostaglandin analogues are administered by non-invasive routes. The most effective medical method is combining a prostaglandin analogue with mifepristone. The consequence of these developments is that abortion in the second trimester can be be performed significantly more effectively and that the currently recommended methods being used are associated with fewer side effects and complications. Language: English Keywords: SWEDEN | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | HYSTEROTOMY | ABORTION | PREGNANCY, SECOND TRIMESTER | PROSTAGLANDINS | CHANGES | Europe, Northern | Europe | Developed Countries | Demographic Factors | Population | Gynecologic Surgery | Urogenital Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Endocrine System | Physiology | Biology | Social Change | Sociocultural Factors Document Number: 330090 Notification |
| 2. Peer Reviewed Title: Concurrent versus sequential methods for labor induction at term. Author: Khan RA; Khan ZE; Ashraf O Source: International Journal of Gynecology and Obstetrics. 2007 Feb;96(2):94-97. Abstract: The objective was to determine the efficacy and safety of the concurrent administration of oxytocin and prostaglandin E2 (PGE2) for induction of labor at term, prompt delivery, and good maternal and neonatal outcomes. In this comparative cohort study of 70 women conducted in Pakistan, 35 were given oxytocin and PGE2 concurrently and 35 were given the drugs sequentially for labor induction. Two-sample t tests and x/2 tests were used for the evaluation of continuous and categorical data, respectively. The mean induction to delivery time was shorter by 2.4 h in the concurrent treatment group (P < 0.001), and the proportion of vaginal deliveries was higher in that group. The concurrent method of induction of labor resulted in shorter induction to delivery time and a higher proportion of vaginal deliveries. (author's) Language: English Keywords: PAKISTAN | RESEARCH REPORT | COHORT ANALYSIS | PREGNANT WOMEN | OXYTOCIN | CHILDBIRTH | PROSTAGLANDINS | Asia, Southern | Asia | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Pituitary Hormones | Hormones | Endocrine System | Physiology | Biology | Pregnancy Outcomes | Pregnancy | Reproduction Document Number: 312025 |
| 3. Peer Reviewed Title: Induction of labor with misoprostol or oxytocin in Tanzania. Author: Kidanto HL; Kaguta MM; van Roosmalen J Source: International Journal of Gynecology and Obstetrics. 2007 Jan;96(1):30-31. Abstract: The aim of this study is to compare the safety, efficacy and cost effectiveness of vaginal misoprostol and intravenous oxytocin in induction of labor. A randomized trial was performed in 142 women requiring labor induction in Muhimbili National Hospital, Dar es Salaam Tanzania from June to December 2004. Inclusion criteria were singleton vertex presentation; gestational age >36 weeks. Exclusion criteria were previous myomectomy, uteroplasty, or cesarean section. Sequential sealed envelopes generated by computer were used. Patients were assigned to receive either oxytocin or 25 mcg 4-hourly vaginal misoprostol (Continental pharma Inc, Belgium; maximum dose 100 mcg). If contractions were not established 4 h after the insertion of the fourth misoprostol, induction was considered a failure, and the patient was managed according to hospital protocols. In the oxytocin group, infusion of 5 I in 500 ml of 5% dextrose (10 mU/ ml) was started (maximum dosage 40 mU/min). If labor was not established within 12 h, induction was regarded as a failure and the patient was managed according to hospital protocols. (excerpt) Language: English Keywords: TANZANIA | SUMMARY REPORT | COMPARATIVE STUDIES | CLINICAL TRIALS | MISOPROSTOL | OXYTOCIN | PROSTAGLANDINS | SAFETY | CONTRACEPTIVE USE-EFFECTIVENESS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Clinical Research | Prostaglandins, Synthetic | Endocrine System | Physiology | Biology | Pituitary Hormones | Hormones | Public Health | Health | Contraceptive Effectiveness | Contraception | Family Planning Document Number: 311564 |
| 4. Title: Experimental studies on cyclooxygenase-2 inhibitor induced cervical cancer hela cell apoptosis and its molecular mechanism. Author: Yin L; Wei LB; Qu QH; Guo XP Source: Journal of Reproduction and Contraception. 2007 Dec;18(4):271-277. Abstract: The objective was to investigate the Hela cells growth inhibition and apoptosis possible molecular mechanisms. Hela cells were treated with various concentrations (100 micromol/L,200 micromol/L, 300 micromol/L,400 micromol/L) of NS-398 (selective for COX-2 inhibition). Cell growth was measured by MTT (Thiazolyl blue). Apoptosis was detected by double staining flow cytometry (FCM). Levels of PGE2 were measured by radioimmunoassay. The expressions of COX-2 protein were also examined by Western blot analysis. After treated with different concentrations of NS-398, the growth of Hela cells was suppressed significantly in a dose-and time-dependent manner (P less than 0.01). The NS-398 can induce apoptosis with the apoptosis rates at 8.53%-43.46% by FCM in a dose-dependent manner. The release of PGE2 was reduced in Hela cells with the values of 69.26 plus or minus 2.13, 47.46 plus or minus 2.18, 28.15 plus or minus 1.64 and 17.01 plus or minus 1.12, respectively, there was significant difference comparedwith control group (83.78 plus or minus 1.11) (P less than 0.01). The NS-398 could inhibit the activity and expression of COX-2 in a dose-dependent manner and down-regulated the expression of COX-2 protein greatly. NS-398 could inhibit the proliferation and increase apoptosis in human Hela cells. These effects may be depended on the inhibition of the expression of COX-2 and PGE2 by NS-398. (author's) Language: English Keywords: CHINA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | CERVICAL CANCER | PROSTAGLANDINS | ENZYMES | CYTOLOGIC EFFECTS | Asia, Eastern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Cancer | Neoplasms | Diseases | Endocrine System | Physiology | Biology | Enzymes and Enzyme Inhibitors Document Number: 326191 |
5.  Title: Frequently asked clinical questions about medical abortion. Author: International Consensus Conference on Non-surgical (Medical) Abortion in Early First Trimester on Issues Related to Regimens and Service Delivery (2004: Bellagio) Source: Geneva, Switzerland, World Health Organization [WHO], 2006. 35 p. Abstract: On 1--5 November 2004, in Bellagio, Italy, the UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), organized a meeting entitled International Consensus Conference on Non-surgical (Medical) Abortion in Early First Trimester on Issues Related to Regimens and Service Delivery. This document is the result of the deliberations of the participants in that meeting, who included highly experienced researchers and clinicians in the area of medical abortion. Prior to the meeting health-care personnel providing abortion services in various countries were asked to provide a list of the most frequently asked questions about medical abortion. The meeting participants reviewed those questions and compiled answers to them based on the scientific literature and their own clinical experience. The answers are presented in this publication. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | MANUAL | PREGNANT WOMEN | HEALTH PERSONNEL | ABORTION | COUNSELING | PROSTAGLANDINS | RU-486 | WHO | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Clinic Activities | Program Activities | Programs | Organization and Administration | Endocrine System | Physiology | Biology | Hormone Antagonists | Hormones | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors Document Number: 312292 |
| 6. Title: Cyclooxygenase-2 expression is higher in ovarian cancer tissue adjacent to endometriosis than in ovarian cancer without comorbid endometriosis. Author: Chou YC; Chen YJ; Lai CR; Wang PH Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2006;124:101-105. Abstract: The purpose of this study was to examine if COX-2, CK7 and CK20 are involved in the malignant transformation of endometriosis. We compared COX-2, CK7 and CK20 expressions between isolated endometriosis lesions and endometriosis lesions adjacent to ovarian carcinoma and between isolated ovarian carcinoma and ovarian carcinoma with implants of endometriosis. Immunoreactivity was quantified using an immunohistochemical scoring system that corresponds to an image analysis-based system. There was no difference in COX-2, CK7 and CK20 expressions between the isolated endometriosis lesions and the endometriosis lesions adjacent to ovarian carcinoma. Similarly, CK7 and CK20 were equally expressed between the isolated ovarian carcinoma and the ovarian carcinoma with implants of endometriosis. The COX-2 over-expression rate was greater in ovarian carcinoma that was associated with endometriosis than in isolated ovarian carcinoma (27.8% versus 5.6%, P = 0.083). In endometrioid type ovarian carcinoma, the difference in COX-2 expression was statistically significant (50% versus 0%, P = 0.023). COX-2 over-expression may be a result of the malignant transformation of endometriosis to endometrioid type ovarian cancer or may represent an interaction between the two cellular components. With respect to cytokeratins, neither CK7 nor CK20 appear to be involved in the malignant transformation of endometriosis. (author's) Language: English Keywords: TAIWAN | RESEARCH REPORT | COMPARATIVE STUDIES | WOMEN | PROSTAGLANDINS | CYTOCHEMICAL EFFECTS | OVARIAN CANCER | ENDOMETRIOSIS | Asia, Eastern | Asia | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Endocrine System | Physiology | Biology | Cytologic Effects | Cancer | Neoplasms | Diseases Document Number: 293393 |
| 7. Peer Reviewed Title: Mifepristone and prostaglandin for termination of pregnancy: contraindications for use, reasons and rationale. Author: Davey A Source: Contraception. 2006 Jul;74(1):16-20. Abstract: Drug therapies are usually contraindicated in specific patient populations where evidence suggests that administration may result in a serious reaction or may seriously and negatively alter the risk benefit of treatment. There are few absolute contraindications to licensed regimens of mifepristone and prostaglandin for termination of pregnancy. However, those that are specified on "summary of product characteristics" [product labeling (PL)] differ from country to country. Differences reflect the dynamic environment of emerging scientific evidence, local experience and guidelines, and local regulatory processes, which all influence the resultant PL. The reasons and rationale for specific contraindications for mifepristone and prostaglandin for the termination of pregnancy are detailed, and the reasons for the differences between PL in different countries are explained. (author's) Language: English Keywords: FRANCE | LITERATURE REVIEW | ABORTION | RU-486 | PROSTAGLANDINS | CONTRAINDICATIONS | RISK FACTORS | ADMINISTRATION AND DOSAGE | Europe, Western | Europe | Developed Countries | Fertility Control, Postconception | Family Planning | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs Document Number: 300867 Notification |
| 8. Title: Marine oil, and other prostaglandin precursor, supplementation for pregnancy uncomplicated by preeclampsia or intrauterine growth restriction (Review). Author: Makrides M; Duley L; Olsen SF Source: Cochrane Database of Systematic Reviews. 2006;(3):[75] p.. CD003402 Abstract: Population studies have shown that higher intakes of marine foods during pregnancy are associated with longer gestations, higher infant birthweights and a low incidence of pre-eclampsia. It is suggested that the fatty acids of marine foods may be the underlying cause of these associations. The objectives were to estimate the effects of marine oil, and other prostaglandin precursor, supplementation during pregnancy on the risk of pre-eclampsia, preterm birth, low birthweight and small-for-gestational age. We searched the Cochrane Pregnancy and Childbirth Group Trials Register (December 2005), The Cochrane Central Register of Controlled Trials (The Cochrane Library 2005, Issue 2) and MEDLINE (1966 to April 2005). All randomised trials comparing oral marine oil, or other prostaglandin precursor, supplementation during pregnancy with either placebo or no treatment. Trials were excluded if their aim was to treat women with established pre-eclampsia or suspected intrauterine growth restriction. Two review authors independently assessed trials for inclusion, data extraction and trial quality. Six trials, involving 2783 women, are included in this review. Three of these were rated as high quality, including the largest trial with 1477 women. Women allocated a marine oil supplement had a mean gestation that was 2.6 days longer than women allocated to placebo or no treatment (weighted mean difference (WMD), 2.55 days, 95% confidence interval (CI) 1.03 to 4.07 days; 3 trials, 1621 women). This was not reflected in a clear difference between the two groups in the relative risk (RR) of birth before 37 completed weeks, although women allocated marine oil did have a lower risk of giving birth before 34 completed weeks' gestation (RR 0.69, 95% CI 0.49 to 0.99; 2 trials, 860 women). Birthweight was slightly greater in infants born to women in the marine oil group compared with control (WMD 47 g, 95% CI 1 g to 93 g; 3 trials, 2440 women). However, there were no overall differences between the groups in the proportion of low birthweight or small-for-gestational age babies. There was no clear difference in the relative risk of pre-eclampsia between the two groups. There is not enough evidence to support the routine use of marine oil, or other prostaglandin precursor, supplements during pregnancy to reduce the risk of pre-eclampsia, preterm birth, low birthweight or small-for-gestational age. (author's) Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | CLINICAL TRIALS | PREGNANT WOMEN | PREECLAMPSIA | HYPERTENSION | PREGNANCY COMPLICATIONS | PROSTAGLANDINS | LOW BIRTH WEIGHT | FOOD AND BEVERAGE | LIPID METABOLIC EFFECTS | North America | Americas | Developed Countries | Clinical Research | Research Methodology | Population Characteristics | Demographic Factors | Population | Diseases | Vascular Diseases | Endocrine System | Physiology | Biology | Birth Weight | Body Weight | Nutrition | Health | Lipids Document Number: 307759 |
| 9. Peer Reviewed Title: Frequently asked questions about medical abortion. Author: von Hertzen H; Baird D Source: Contraception. 2006 Jul;74(1):3-10. Abstract: The development of methods of inducing abortion medically (nonsurgically) has created alternative options to make abortion available to women in a variety of health-care settings. Medical abortion is induced with a regimen of mifepristone followed by a prostaglandin analogue. Since its first introduction in the late 1980s, the regimen has undergone some modifications based on research evidence, and, in many countries, clinicians are using regimens that may differ from the one that has been licensed. This causes confusion among providers, also because only a few countries have developed national guidelines for the provision of medical abortion. We approached health care personnel providing abortion services in various countries and asked them to send us questions that they, or their colleagues, might have concerning the clinical practice of medical abortion in the early first trimester (up to 63 days since the first day of the last menstrual period). These questions were sent to experts representing the fields of biomedical and clinical research, clinical practice and family planning, who conducted literature reviews so that, whenever possible, the answers could be based on existing evidence. A consensus meeting was held in Bellagio, Italy, between November 1 and 5, 2004, to review the questions and to discuss the answers. The aim of this article is to provide a brief overview of some of the questions asked and the answers discussed. (author's) Language: English Keywords: GLOBAL | LITERATURE REVIEW | RECOMMENDATIONS | PROVIDERS WITH CLIENTS | ABORTION | POSTABORTION CARE | COUNSELING | RU-486 | PROSTAGLANDINS | ADMINISTRATION AND DOSAGE | Health Services | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Clinic Activities | Program Activities | Programs | Organization and Administration | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Drugs | Treatment | Medical Procedures | Medicine Document Number: 300865 Notification |
| 10. Title: Early medical abortion: a new regimen up to 49 days' gestation. Author: Ashima T; Vinita A; Shalini R Source: Australian and New Zealand Journal of Obstetrics and Gynaecology. 2005 Apr;45(5):137-139. Abstract: The aim was to evaluate a new regimen of mifepristone and misoprostol in early medical abortion up to 49 days of amenorrhoea. One hundred healthy women requesting pregnancy termination up to 49 days gestation received 200 mg mifepristone followed by 800 µg misoprostol orally 24 h later. Statistical analysis was carried out by unpaired t-test. Ninety-six percent of patients aborted completely 4.3 h after they were given misoprostol. No significant side-effects were noted. The duration of bleeding correlated with gestational age (P-value 0.009). This new regimen of mifepristone-misoprostol is effective in terminating early pregnancy, with shorter induction to abortion interval and greater acceptability. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | PROSPECTIVE STUDIES | PREGNANT WOMEN | PREGNANCY | GESTATIONAL AGE | PROSTAGLANDINS | RU-486 | MISOPROSTOL | ADMINISTRATION AND DOSAGE | ABORTION | CONTRACEPTIVE USE-EFFECTIVENESS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Reproduction | Fetus | Endocrine System | Physiology | Biology | Hormone Antagonists | Hormones | Prostaglandins, Synthetic | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Contraceptive Effectiveness | Contraception Document Number: 310295 Notification |
| 11. Peer Reviewed Title: Medical abortion for Australian women: it's time. Author: De Costa CM Source: Medical Journal of Australia. 2005;183(7):378-380. Abstract: Recently, a young woman from a rural community presented to a doctor in a small country hospital some distance from her home, requesting termination of pregnancy. She was the mother of two children aged under 3 years, both delivered before 32 weeks gestation because of severe pre-eclampsia. Her partner was unsupportive. At presentation, she was 8 weeks pregnant. The doctor was sympathetic to her request but was unable to arrange surgical termination in the country hospital. He advised that she would need to travel, by bus and at her own expense, several hundred kilometres to the nearest large town, where an abortion could be performed in a private clinic. The cost would be more than $700 in all. This was completely beyond this woman’s resources, and she returned home still pregnant. At 26 weeks of pregnancy, she presented again to the country hospital, severely ill with pre-eclampsia. She was transferred by air to the town in which she might have had the pregnancy terminated, where she underwent emergency caesarean section in a public hospital. The infant died within 24 hours, and the woman spent several days in a highdependency unit. The cost of her transfer and hospitalisation was covered from the public purse. (excerpt) Language: English Keywords: AUSTRALIA | RECOMMENDATIONS | CLINICAL RESEARCH | PREGNANT WOMEN | POLICYMAKERS | ABORTION | RU-486 | CONTRACEPTIVE SAFETY | CONTRACEPTIVE EFFECTIVENESS | PROSTAGLANDINS | CONTRACEPTIVE AVAILABILITY | HEALTH POLICY | Developed Countries | Oceania | Research Methodology | Population Characteristics | Demographic Factors | Population | Administrative Personnel | Organization and Administration | Fertility Control, Postconception | Family Planning | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Safety | Public Health | Health | Contraception | Policy Document Number: 284853 Notification |
| 12. Title: Trends in abortion in Iran: 1994-2002. Author: Fallahian M; Mohammad-Zadeh F Source: Archives of Iranian Medicine. 2005;8(3):217-218. Abstract: In all societies, regardless of the legal, moral, or cultural issues of abortion, there are some women who desperately seek to terminate an unwanted pregnancy. With the growing desire to limit childbearing to one or two children, and while accessibility to effective contraception is limited, abortion is common worldwide. This hospital-based study was conducted to determine the abortion complications and outcome of pregnancy. About 78% of the 75 cases studied attempted to induce abortion through injection of prostaglandin (Prostine) but others attempted by curettage. Forty percent of females had complete abortion, 18.5% had failed abortion, and the remaining had incomplete abortion. The use of prostaglandin alone has been replaced by curettage, but it succeeds in terminating pregnancy in just 40% of the cases. (author's) Language: English Keywords: IRAN | RESEARCH REPORT | QUESTIONNAIRES | PREGNANT WOMEN | PREGNANCY, UNWANTED | PREVALENCE | ABORTION | COMPLICATIONS | PROSTAGLANDINS | PREGNANCY OUTCOMES | CONTRACEPTION | PROGRAM ACCESSIBILITY | CONTRACEPTIVE USE-EFFECTIVENESS | Middle East | Developing Countries | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Measurement | Research Methodology | Fertility Control, Postconception | Family Planning | Diseases | Endocrine System | Physiology | Biology | Pregnancy | Reproduction | Program Evaluation | Programs | Organization and Administration | Contraceptive Effectiveness Document Number: 291490 Notification |
| 13. Peer Reviewed Title: The effect of non-steroidal anti-inflammatory drugs on medical abortion with mifepristone and misoprostol at 13-22 weeks gestation. Author: Fiala C; Swahn ML; Stephansson O; Gemzell-Danielsson K Source: Human Reproduction. 2005 Nov;20(11):3072-3077. Abstract: Non-steroidal anti-inflammatory drugs (NSAIDs) inhibit the biosynthesis of prostaglandins and concerns have been expressed that they might attenuate the effects of exogenous prostaglandins. This randomized study was conducted to evaluate whether NSAID given during medical abortion with mifepristone/misoprostol in the second trimester has a negative effect on the efficacy of the abortifacient by prolonging the induction-to-abortion interval. Seventy-four women were treated with the anti-progesterone mifepristone, followed by repeated doses of misoprostol 36–48 h later. They were randomized to receive a prophylactic pain treatment of either paracetamol and codeine or diclofenac with the first dose of misoprostol. Co-treatment of NSAID with misoprostol did not attenuate the efficacy of mifepristone and misoprostol. There was no significant difference between the NSAID and the non-NSAID group in the induction-to-abortion interval (5.4 versus 6.5 h) or the total doses of misoprostol needed (2 versus 3). The frequency of surgical intervention was similar (55.6 versus 52.6%). Women in the group treated with NSAID required significantly less opiates (P = 0.042). Co-treatment with NSAID and misoprostol does not interfere with the action of mifepristone and/or misoprostol to induce uterine contractions and pregnancy expulsion in medical abortion. Prophylactic NSAID administration reduces the need for opiate injections. (author's) Language: English Keywords: SWEDEN | RESEARCH REPORT | CLINICAL RESEARCH | PREGNANT WOMEN | RU-486 | MISOPROSTOL | ABORTION | PROSTAGLANDINS | PROGESTERONE | TIME FACTORS | ANALGESIA | PROSTAGLANDINS, ADMINISTRATION AND DOSAGE | PREGNANCY, SECOND TRIMESTER | Developed Countries | Europe, Northern | Europe | Research Methodology | Population Characteristics | Demographic Factors | Population | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Prostaglandins, Synthetic | Fertility Control, Postconception | Family Planning | Progestational Hormones | Population Dynamics | Treatment | Pregnancy | Reproduction Document Number: 292342 Notification |
| 14. Peer Reviewed Title: Which factors influence the number of gemeprost pessaries used in inducing second-trimester abortions? Author: Kaasen A; Naes T; Haugen G Source: Acta Obstetrica et Gynecologica Scandinavica. 2005;84:371-375. Abstract: Background. The course of second-trimester abortions with the intention to use gemeprost as the only abortifacient is described. Methods: The report is based on 278 consecutive second-trimester abortions, excluding missed abortions, during a 12-year period in a tertiary referral center. The women were treated with 1 mg gemeprost pessaries every fourth hour with a maximum of five applications during 24 h. If abortion had not occurred, a new treatment of gemeprost was prescribed after an interval of 12 h. Results: The median number of gemeprost pessaries used was 4 (range 1-16) and the mean number (±SD) 4.09 (±1.90). Abortion occurred within 24 h in 78% of the women and within 48 h in 96%. The efficiency of gemeprost was highly dependent on previous vaginal deliveries (p=<0.001), with a mean number of applications of 4.63 (±2.04), 3.93 (±1.74), and 3.13 (±1.26) in those with none, one, and two or more previous vaginal deliveries, respectively. Previous spontaneous abortions were associated with a lower number of applications. Including previous vaginal deliveries and spontaneous abortions in a two-way analysis of variance (ANOVA), only the number of spontaneous abortions was marginally significant (p=0.05). After excluding four patients with three or more spontaneous abortions from the analysis, the number of previous vaginal deliveries was significant (p=0.010) whereas that of spontaneous abortions became nonsignificant. Postprocedure complications were reported in 13% of the women. Conclusion. The course of the abortions was dependent on previous vaginal deliveries and spontaneous abortions. (author's) Language: English Keywords: NORWAY | RESEARCH REPORT | CLINICAL RESEARCH | PREGNANT WOMEN | PREGNANCY, SECOND TRIMESTER | PROSTAGLANDINS | ABORTION | PROSTAGLANDINS, ADMINISTRATION AND DOSAGE | ABORTION, SPONTANEOUS | CONTRACEPTIVE SAFETY | CONTRACEPTIVE EFFECTIVENESS | Developed Countries | Europe, Northern | Europe | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Endocrine System | Physiology | Biology | Fertility Control, Postconception | Family Planning | Pregnancy Complications | Diseases | Safety | Public Health | Health | Contraception Document Number: 283209 Notification |
| 15. Title: Medical versus surgical methods for first trimester termination of pregnancy. Author: Say L; Kulier R; Gülmezoglu M; Campana A Source: Cochrane Database of Systematic Reviews. 2005 Jan;(1):[178] p.. Art. No.: CD003037.pub2 Abstract: Induced abortions are very commonly practiced interventions worldwide. A variety of medical abortion methods have been introduced during the last decade in addition to existing surgical methods. In this review we systematically searched for and combined all evidence from randomised controlled trials comparing surgical with medical abortion. Objectives: To evaluate medical methods in comparison to surgical methods for first-trimester abortion with respect to efficacy, side effects and acceptability. The Cochrane Controlled Trials Register, MEDLINE (with the Cochrane 3-stage search strategy)(1966-2000) and Popline (1970-2000) were systematically searched. There were no language preferences in searching. Reference lists of retrieved papers were searched. Experts in WHO/HRP were contacted. Randomised trials of any surgical abortion method compared with any medical abortion method in the first trimester. Trial quality was assessed and data extraction was made independently by two reviewers. Five studies mostly with small sample sizes, comparing 4 different interventions (prostaglandins alone, mifepristone alone, and mifepristone/misoprostol and methotrexate/misoprostol versus vacuum aspiration) were included. Results are sometimes based on one trial only. Prostaglandins vs vacuum aspiration: the rate of abortions not completed with the intended method was statistically significant higher in the prostaglandin group (2.7, 95% CI 1.1 to 6.8) compared to surgery. There are no data on the most commonly medical (mifepristone/misoprostol) and surgical abortion available to be included in the review. Duration of bleeding was longer in the medical abortion groups compared to vacuum aspiration. There was only one major complication (uterine perforation) in one trial in the surgical group. There was no difference between the groups for ongoing pregnancies at the time of follow-up or pelvic infections. No data on acceptability, side effects or women's satisfaction with the procedure were available for inclusion in the review. The results are derived from small trials. Prostaglandins used alone seems to be less effective and more painful compared to surgical first-trimester abortion. However, there is inadequate evidence to comment on the acceptability and side effects of medical compared to surgical first-trimester abortions. There is a need for trials to address the efficacy of currently used methods and women's preferences more reliably. (author's) Language: English Keywords: GLOBAL | DATA COLLECTION | DATA ANALYSIS | WOMEN | ABORTION | INTERVENTIONS | PROSTAGLANDINS | BLEEDING | CONTRACEPTIVE METHOD ACCEPTABILITY | Research Methodology | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Programs | Organization and Administration | Endocrine System | Physiology | Biology | Signs and Symptoms | Diseases | Contraceptive Usage | Contraception Document Number: 195563 Notification |
| 16. Peer Reviewed Title: Comparison of gemeprost and vaginal misoprostol in first trimester mifepristone-induced abortion. Author: Svendsen PF; Rorbye C; Vejborg T; Nilas L Source: Contraception. 2005;72:28-32. Abstract: The aim of this study was to compare efficacy and side effects of gemeprost and vaginal misoprostol in mifepristone-induced abortions in women up to 63 days of gestation. A retrospective study of 833 consecutive patients admitted for medical termination of first trimester pregnancy was conducted. Four-hundred ten patients received mifepristone 600 mg, followed 48 h later by gemeprost 1 mg (regimen I), and 423 patients received mifepristone 200 mg followed by vaginal misoprostol 800 µg (regimen II). Success rates were evaluated after 2 weeks and after 3 months. The severity of bleeding and side effects (pain, nausea, vomiting and diarrhea) was scored by the patients, and requests for supplementary analgesic treatment were recorded by the attending nurse. Success rates were 99% in both groups after 2 weeks of follow-up. At 3 months of follow-up, success rates had declined to 94% for regimen I and 96% for regimen II. The frequency of severe pain was higher in regimen I compared to regimen II (72% vs. 60%, p < .001), but the severity of bleeding and gastrointestinal side effects was similar in the two regimens. When combined with mifepristone, gemeprost and vaginal misoprostol are equally effective for termination of first trimester abortion, but may be associated with varying intensity of side effects. (author's) Language: English Keywords: DENMARK | RESEARCH REPORT | RETROSPECTIVE STUDIES | CLINICAL RESEARCH | COMPARATIVE STUDIES | PREGNANT WOMEN | MISOPROSTOL | PROSTAGLANDINS | PREGNANCY, FIRST TRIMESTER | ABORTION | ORAL CONTRACEPTIVES, SIDE EFFECTS | RU-486 | ORAL CONTRACEPTIVES, COMBINED | Developed Countries | Europe, Northern | Europe | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Prostaglandins, Synthetic | Endocrine System | Physiology | Biology | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Contraceptive Safety | Safety | Public Health | Health | Hormone Antagonists | Hormones | Oral Contraceptives | Contraceptive Methods | Contraception Document Number: 288298 Notification |
| 17. Title: Comparison of dinoprostone plus oxytocin and oxytocin alone for induction of labor. Author: Valadan M; Niroomanesh S; Noori K; Khalilian S; Tehrani M Source: Acta Medica Iranica. 2005;43(4):259-262. Abstract: Role of labor induction has increased in the last decade due to the early detection of fetal jeopardy. Although very useful, oxytocin alone is not always successful for induction of labor. In a randomized clinical trial we compared vaginal dinoprostone plus oxytocin with oxytocin alone for induction of labor in 91 pregnant women at 40 weeks or greater gestation with Bishop scores = 4. Forty six patients assigned to the dinoprostone group received 3 mg intravaginal dinoprostone. Six hours later the Bishop score was evaluated and if the patient had not at least 3 contractions in 10 minutes lasting for more than 40 seconds, intravenous oxytocin was started at a dose of 6 mu/min and increased by 6 mu/min at 40 minute intervals until adequate uterine activity. Forty five patients assigned to the oxytocin group underwent oxytocin induction from the start of labor induction. Although the Bishop score change after 6 hours of receiving vaginal dinoprostone from 2.54 to 4.97 was statistically significant, the oxytocin only group had a much better response with a change from 2.60 to 6.28. Median time between induction to the start of active labor was significantly shorter in the oxytocin alone group (P = 0.04). Median time between induction to delivery and the rate of cesarean did not differ significantly in these groups (P > 0.05). It was concluded that single dose of dinoprostone is effective for initiating labor in patients with an unfavorable cervix and appears safe but it is not as effective as oxytocin. (author's) Language: English Keywords: IRAN | RESEARCH REPORT | CLINICAL TRIALS | COMPARATIVE STUDIES | PREGNANT WOMEN | PREGNANCY, PROLONGED | CHILDBIRTH | OXYTOCIN | PROSTAGLANDINS | CERVICAL DILATATION | TIME FACTORS | CESAREAN SECTION | Middle East | Developing Countries | Clinical Research | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Pregnancy Outcomes | Pituitary Hormones | Hormones | Endocrine System | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Dynamics | Obstetrical Surgery | Surgery Document Number: 300665 |
| 18. Peer Reviewed Title: Cervical priming with sublingual misoprostol vs. 15-methyl-prostaglandin F2 alpha prior to surgical abortion. Author: Vimala N; Mittal S; Dadhwal V Source: International Journal of Gynecology and Obstetrics. 2005 Feb;88(2):134-137. Abstract: Objective: To compare the efficacy and tolerability of sublingual misoprostol with those of intramuscular 15-methyl-prostaglandin F(-2)a (15-M-PG F(-2)a for cervical dilation prior to vacuum aspiration (VA) in first-trimester pregnancy termination. Methods: Sixty pregnant women requesting pregnancy termination between the 9th and 12th week were randomized to receive 400 µg of sublingual misoprostol or an intramuscular injection of 125 µg of 15-M-PG F(-2)a 2 h prior to vacuum aspiration. Baseline cervical dilation prior to vacuum aspiration was measured using Hegar's dilators. Other variables assessed included procedure duration, intraoperative blood loss, and associated adverse effects. Patient acceptability was assessed by questionnaires completed at the time of discharge from the hospital. Results: Mean cervical dilation at vacuum aspiration was significantly greater in the misoprostol group than in the 15-M- PG F(-2)a group (8.8 vs. 7.6 mm; P<0.01), and preoperative adverse effects were significantly less frequent in the sublingual misoprostol group (P<0.05). However, procedure duration and intraoperative blood loss were similar in both groups. The acceptability rates were 93.3% in the sublingual misoprostol group and 76.6% in the 15-M-PG F(-2)a group, respectively; however, 6.6% patients in the sublingual misoprostol group thought that the tablets had an unpleasant taste. Conclusion: Sublingual misoprostol appears to be an effective alternative to intramuscular 15-M-PG F(-2)a for cervical dilation prior to vacuum aspiration in first trimester pregnancy. In addition, misoprostol is inexpensive and convenient to use and has higher patient acceptability rates. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | PREGNANT WOMEN | ABORTION | PREGNANCY, FIRST TRIMESTER | MISOPROSTOL | PROSTAGLANDINS | CERVICAL DILATATION | Asia, Southern | Asia | Developing Countries | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Prostaglandins, Synthetic | Endocrine System | Physiology | Biology | Treatment Document Number: 280396 Notification |
| 19. Peer Reviewed Title: A comparison of induction with vaginal prostaglandin E2 versus spontaeous of labor in grand multiparous women. Author: Zamzami TY Source: Archives of Gynecology and Obstetrics. 2005 Dec;273(3):176-179. Abstract: The objective was to compare the outcome of labor in grand multiparous women (para 6 or more) who had induction of labor with vaginal prostaglandin E/2 with grand multiparous women in spontaneous labor. A retrospective case-control study was performed, 202 grand multiparous women were induced labor with vaginal prostaglandin E/2 and compared with outcomes with grand multiparous women who entered in spontaneous labor and delivered during the same study period and served as control group. There were no statistically significant differences in the duration of labor, fetal birth weight, use of oxytocin augmentation, and Apgar scores in the two groups. Fourteen women (6.9%) in the induction group delivered by cesarean section compared to six woman (3.0%) in the control group. This was a statistically significant difference (P = 0.01). In the induction group, the mean duration of the hospital stay was longer (P = 0.003) and there was one neonatal fetal death and one uterus rupture. Induction of labor with vaginal prostaglandin E/2 in grand multiparous women is still relatively safe. (author's) Language: English Keywords: SAUDI ARABIA | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | RETROSPECTIVE STUDIES | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | MULTIPARITY | PROSTAGLANDINS | CESAREAN SECTION | CHILDBIRTH | OXYTOCIN | Middle East | Developing Countries | Research Methodology | Studies | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Parity | Fertility Measurements | Fertility | Population Dynamics | Endocrine System | Physiology | Biology | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Pituitary Hormones | Hormones Document Number: 298263 |
| 20. Peer Reviewed Title: Role of routine ultrasonography in monitoring the outcome of medical abortion in a clinical setting. Author: Acharya G; Haugen M; Brathen A; Nilsen I; Maltau JM Source: Acta Obstetrica et Gynecologica Scandinavica. 2004 Apr;83(4):390-394. Abstract: Clinical methods generally used to evaluate the completeness of medical abortion are not accurate. There are no published reports evaluating the role of routine ultrasonography in monitoring the outcome of medical abortion. The purpose of this study was to investigate whether routine transvaginal ultrasonography (TVS) at the follow-up visit after medical abortion can accurately identify women who will require surgical intervention. Retrospective review of medical records and charts of all women undergoing medical abortion in the first trimester of pregnancy between January 1999 and December 2001. Methods. Medical abortion was performed using oral mifepristone and a vaginal prostaglandin analog before 63 days gestation. All women had an initial TVS to confirm intrauterine pregnancy and gestational age, and another TVS at the follow-up visit 2–3 weeks later to assess the completeness of abortion. Surgical evacuation of the uterus was allowed as indicated on clinical grounds but not on the basis of ultrasound findings only. A total of 690 women consented to medical abortion during the study period. Eleven of these women were excluded from the study for various reasons. Of the remaining 679 cases, 95% (645/679) had a documented follow-up at the hospital. The pregnancy termination rate among these women was 99.2% (640/645) and TVS identified all five cases of continuing pregnancy at the follow-up. A total of 66 (10.2%) patients had complications. The uterine cavity was empty on TVS at the follow-up visit in 84.8% (547/645) of cases and only 3.1% (17/547) of them required surgical aspiration/curettage due to excessive or prolonged vaginal bleeding. In the remaining 15.2% (98/645) the uterine cavity was not empty, and 43.9% (43/98) of them had a curettage. The risk of requiring a surgical intervention was significantly higher [odds ratio (OR) 24.4; 95% confidence interval (95% CI) 14.9–39.7] when the uterine cavity was not demonstrated to be empty at the follow-up visit 2–3 weeks after medical abortion. However, 59.1% (55/93) of women did not require surgical intervention despite ultrasound evidence of thick endometrial echo-complex. Routine TVS 2–3 weeks after medical abortion appears to be an efficient means of accurately identifying the cases of ongoing pregnancy and diagnosing a complete abortion. Although TVS could be used as an adjunct to clinical examination to diagnose an incomplete expulsion, it does not accurately differentiate those women who require surgical intervention from those who do not. (author's) Language: English Keywords: NORWAY | CLINICAL RESEARCH | PREGNANT WOMEN | ULTRASONICS | RU-486 | PROSTAGLANDINS | ABORTION | MONITORING | Developed Countries | Europe, Northern | Europe | Research Methodology | Population Characteristics | Demographic Factors | Population | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Fertility Control, Postconception | Family Planning | Evaluation Document Number: 192723 Notification |
| 21. Peer Reviewed Title: Is home-based administration of prostaglandin safe and feasible for medical abortion? Results from a multisite study in Vietnam. Author: Nguyen Thi Nhu Ngoc; Vu Quy Nhan; Blum J; Tran Thi Phuong Mai; Durocher JM Source: BJOG: An International Journal of Obstetrics and Gynaecology. 2004 Aug;111:814-819. Abstract: The objectives were to study the efficacy and acceptability of a simplified medical abortion regimen in Vietnam. The design was an Open-label study. One peri-urban and three urban hospitals and four urban maternal–child health family planning clinics located in Northern, Central and Southern Vietnam. A total of 1601 women seeking abortion services from January 2001 to December 2001. Consenting women presenting for abortion services with gestations less than 56 days LMP who met the inclusion criteria were given 200 mg mifepristone and offered the choice of either home or clinic administration of 400 Ag oral misoprostol two days later. Complete abortion rate of 89.2% (n = 1395), with 1.5% (n = 24) of the women lost to follow up. The majority of women (>90%) reported that their medical abortion experience was either ‘very satisfactory’ or ‘satisfactory’. There was a strong preference for home administration of misoprostol, with more than four-fifths of the study population selecting to administer the prostaglandin at home. Location of misoprostol administration did not affect efficacy rate. Regardless of location selected, women expressed a high degree of satisfaction with the medical abortion experience. Medical abortion with the option of home administration of misoprostol is safe and feasible for introduction into the Vietnamese healthcare system. (author's) Language: English Keywords: VIETNAM | RESEARCH REPORT | PREGNANT WOMEN | ABORTION | PROSTAGLANDINS | ADMINISTRATION AND DOSAGE | SAFETY | HOME CARE | Developing Countries | Asia, Southeastern | Asia | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Endocrine System | Physiology | Biology | Drugs | Treatment | Public Health | Health | Health Services | Delivery of Health Care Document Number: 273712 Notification |
| 22. Peer Reviewed Title: Combined bladder and uterine rupture following prostaglandin-induced midtrimester abortion: an unreported event. Author: Agarwal U; Nanda S; Sangwan K; Singh R Source: Acta Obstetrica et Gynecologica Scandinavica. 2003 Oct;82(10):974-975. Abstract: There are numerous references in the literature where cervical and/or lower segment uterine damage occurred secondary to the sequel of prostaglandin-induced midtrimester abortion but none reporting an injury like our case. Kajanoja et al., in their review of 412 cases of prostaglandin- induced midtrimester abortion, described five cases of cervical rupture (all occurring in primi gravidae) associated with intraamniotic prostaglandin F/2a (2.7%). Three were located posteriorly and one anteriorly, while a lateral wedge-shaped rupture extending to the external cervical os was found in one patient. No cervical ruptures were associated with prostaglandin E/2. The authors concluded that constitutional factors undoubtedly played some role in the etiology of cervical rupture in these cases. Wentz et al., in their series of 102 midtrimester abortions with intraamniotic prostaglandins, reported a 2% incidence of posterior cervical or lower uterine segment dehiscence. The authors concluded that such a level of occurrence demanded that all prostaglandin-induced abortions have a vaginal examination with exploration of the lower uterine segment and cervical canal, so that such lacerations may be immediately detected and repaired. (excerpt) Language: English Keywords: INDIA | PREGNANT WOMEN | PREGNANCY, FIRST TRIMESTER | UTERINE PERFORATION | ABORTION | PROSTAGLANDINS | Asia, Southern | Asia | Developing Countries | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Perforations | Diseases | Fertility Control, Postconception | Family Planning | Endocrine System | Physiology | Biology Document Number: 192700 Notification |
| 23. Peer Reviewed Title: Induction of labour using low and high dose regimens of prostaglandin E2 vaginal tablets. Author: Bahar AM; Archibong EI; Zaki ZM; Mahfouz AA Source: East African Medical Journal. 2003 Jan;80(1):51-55. Abstract: Objective: To compare the efficacy of low dose prostaglandin E2 vaginal tablets with that of high dose in induction of labour. Design: A retrospective study. Setting: Abha Maternity Hospital, a teaching hospital in the southern region of Saudia Arabia. Patients: The outcome of induction of labour in 73 women induced with 1.5 mg prostaglandin E2 vaginal tablets was compared with those in 168 women induced with 3 mg vaginal tablets. Results: There were no statistical significant differences in the success rate, induction delivery interval, caesarean section rate and Apgar score between the two groups. There were two incidences of uterine hyperstimulation and two of uterine rupture in the high dose group. These were not statistically significant. Logistic regression analysis showed that the success rate of induction of labour was dependent only on maternal age (P=0.0025) and Bishop score (P=0.0403) and not on parity, gestational age, birthweight or dose of prostaglandin. Conclusion: The low dose regimen of 1.5 mg is as efficacious as the high dose regimen of 3mg. prostaglandin E2 vaginal tablets in inducing labour. This implies that using the low dose regimen reduces the cost of induction of labour effectively. Larger prospective randomized studies are needed to confirm this finding. (author's) Language: English Keywords: SAUDI ARABIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | STATISTICAL REGRESSION | PREMATURE LABOR | PROSTAGLANDINS | VAGINAL TABLET | CONTRACEPTIVE USE-EFFECTIVENESS | PREMATURE BIRTH | Developing Countries | Middle East | Studies | Research Methodology | Data Analysis | Pregnancy Outcomes | Pregnancy | Reproduction | Endocrine System | Physiology | Biology | Vaginal Spermicides | Contraceptive Methods | Contraception | Family Planning | Contraceptive Effectiveness Document Number: 177840 |
| 24. Peer Reviewed Title: Intracervical misoprostol and prostaglandin E2 for labor induction. Author: Chang YK; Chen WH; Yu MH; Liu HS Source: International Journal of Gynecology and Obstetrics. 2003 Jan;80(1):23-28. Abstract: Objectives: To compare the safety and efficacy of misoprostol with PGE2 for induction of labor by intracervical administration. Methods: Eighty-six women with indications for labor induction at term were randomly assigned to two groups. Each woman received either 50 mg of misoprostol or 0.5 mg of prostaglandin E2 intracervically. If labor was not initiated after 4 h, the same dose was repeated every 4 h to a maximum of 200 mg of misoprostol or 1.5 mg of PGE2 until adequate labor was achieved. Results: Forty-three women were allocated to the misoprostol group and 43 to the prostaglandin E2 group. Misoprostol was more effective than PGE2 in producing cervical changes (P<0.025). Delivery within 12 h after the first administration occurred more often in the misoprostol group than in the PGE2 one (85% vs. 56%, P<0.05). Less patients in the misoprostol group required oxytocin augmentation than in the PGE2 one (16.3% vs. 39.5%, P<0.05). Uterine tachysystole and hyperstimulation occurred more frequently in the misoprostol group (44.1%) than in the PGE2 group (18.7%) (P<0.05). Nevertheless, no statistically significant differences were noted between the two groups including mode of delivery and neonatal or maternal adverse outcome. The interval from induction to vaginal delivery was significantly shorter in the misoprostol group (480 =/- 172 min vs. 657 =/- 436 min, P<0.01). Conclusions: Compared with prostaglandin E2, intracervical misoprostol is more effective in cervical ripening and labor induction at term. The higher frequency of uterine hypercontractility associated with the use of misoprostol did not increase the risk of adverse intrapartum and neonatal outcomes. (author’s) Language: English Keywords: TAIWAN | RESEARCH REPORT | CLINICAL RESEARCH | COMPARATIVE STUDIES | PREGNANCY OUTCOMES | MISOPROSTOL | PROSTAGLANDINS | SAFETY | Asia, Eastern | Asia | Developed Countries | Research Methodology | Studies | Pregnancy | Reproduction | Prostaglandins, Synthetic | Endocrine System | Physiology | Biology | Public Health | Health Document Number: 174290 |
| 25. Title: Midtrimester abortion in patients with a previous uterine scar. Author: Debby A; Golan A; Sagiv R; Sadan O; Glezerman M Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2003 Aug 15;109(2):177-180. Abstract: Objective: To investigate whether extraamniotic prostaglandin E2 (PGE2) for midtrimester pregnancy interruption in women with a scarred uterus has any adverse effects compared to those without an uterine scar. Study design: Two hundred and sixty-two women who underwent second trimester (16–27 gestational weeks) termination of pregnancy were enrolled in this study. Thirty-one women with a uterine scar were compared with 231 patients without a scarred uterus. Extraamniotic PGE2 was applied in serial doses of 200 mcg every 2 h up to 20 doses. Intravenous infusion of oxytocin was added in cases when the fetus was not expelled. Curettage was performed in the majority of the patients. Results: The two groups were similar for indications for pregnancy termination, maternal age and gestational age. Gravidity and parity were significantly higher in the group with an uterine scar. The mean induction to abortion time and the complication rate were similar in both groups. No uterine rupture was observed. Conclusion: Extraamniotic PGE2 for midtrimester termination of pregnancy is a safe procedure with a low complication rate, even in patients with an uterine scar. (author's) Language: English Keywords: ISRAEL | CLIENTS | RESEARCH REPORT | CLINICAL RESEARCH | ABORTION | PREGNANCY, SECOND TRIMESTER | PROSTAGLANDINS | OXYTOCIN | UTERINE EFFECTS | CESAREAN SECTION | CURETTAGE | COMPLICATIONS | Middle East | Developed Countries | Program Activities | Programs | Organization and Administration | Research Methodology | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Endocrine System | Physiology | Biology | Pituitary Hormones | Hormones | Uterus | Genitalia, Female | Genitalia | Urogenital System | Obstetrical Surgery | Surgery | Treatment | Diseases Document Number: 182088 Notification |
| 26. Title: Hemostatic cervical suturing technique for management of uncontrollable postpartum haemorrhage originating from the cervical canal. Author: Kafali H; Demir N; Soylemez F; Yurtseven S Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2003 Sep 10;110(1):35-38. Abstract: Objective: To evaluate the efficacy and safety of a novel cervical suturing technique for management of uncontrollable postpartum haemorrhage originating from the cervical canal. Study design: Cervical suturing was performed on three women to control intractable postpartum haemorrhage originating from the cervical canal and not responding to classic management. Haemostatic cervical suturing by using no. 1 chromic catgut is a new surgical technique which approximates anterior and posterior cervical lips. It controls cervical haemorrhage by attachment and compression of the haemorrhage site of the cervical lips and lower uterine segment. Results: The procedure was effective in all cases and hysterectomy was not needed in any case. No complication occurred and the survival rate was 100%. The procedure required no special expertise or extraordinary equipment. Conclusion: Cervical suturing technique for management of postpartum haemorrhage originating from the cervical canal is an easy, safe and highly effective conservative surgical technique that may be alternative to hysterectomy. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | CLINICAL RESEARCH | POSTPARTUM WOMEN | BLEEDING | WOMEN | CERVICAL LACERATION | OBSTETRICAL SURGERY | PROSTAGLANDINS | Developing Countries | Europe, Southeastern | Europe | Research Methodology | Puerperium | Reproduction | Signs and Symptoms | Diseases | Demographic Factors | Population | Surgery | Treatment | Endocrine System | Physiology | Biology Document Number: 187546 |
| 27. Title: Second-trimester pregnancy termination: comparison of three different methods. Author: Makhlouf AM; Al-Hussaini TK; Habib DM; Makarem MH Source: Journal of Obstetrics and Gynaecology. 2003 Jul;23(4):407-411. Abstract: The object of this study was to compare intravaginal misoprostol and dinoprostone (prostaglandin E/2) for second-trimester pregnancy termination, and to examine the role of the nitric oxide donor, glyceryl trinitrate, as a possible alternative to prostaglandins to induce cervical ripening in second-trimester pregnancy termination. This was a randomised clinical trial. The trial involved pregnant women between 13 and 28 weeks’ gestation admitted with clear medical or obstetric indications for pregnancy termination, and was carried out in the department of obstetrics and gynecology, Assiut University Hospital, Egypt. Patients were classified into Group A, where pregnancy termination was induced by vaginal misoprostol 100 micrograms every 4 hours with a maximum dose of 500 micrograms; Group B, where induction was by vaginal dinoprostone 6 mg every 6 hours with a maximum dose of 24 mg; and Group C, where induction involved vaginal glyceryl trinitrate 500 micrograms every 6 hours with a maximum dose of 2.5 mg. Twenty-four hours after the start of induction, the rate of complete abortion in the three groups was 100%, 66.67% and 0%, respectively. The rate of complete abortion was 100% in the nitric oxide (glyceryl trinitrate)-induced group after introducing a complementary procedure. The induction – abortion interval was significantly shorter, the number of doses needed was less and the maximum Bishop score reached was greater with misoprostol than with dinoprostone. A higher rate of side effects occurred with the misoprostol-induced group (74%) compared with the other two groups (46.6% and 0%). Misoprostol is a cheap, effective drug for second-trimester pregnancy termination with short induction abortion intervals but a higher rate of side effects. Prostin E/2 is also effective in termination of second-trimester pregnancy but is expensive and may require high doses to be administered. Glyceryl trinitrate is an effective drug for cervical ripening (softening) but it has no role in the stimulation of uterine contractions. (author's) Language: English Keywords: EGYPT | RESEARCH REPORT | CLINICAL TRIALS | COMPARATIVE STUDIES | PREGNANT WOMEN | PREGNANCY, SECOND TRIMESTER | ABORTION | PROCEDURES | MISOPROSTOL | PROSTAGLANDINS | COST EFFECTIVENESS | Developing Countries | Africa, North | Africa | Clinical Research | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Organization and Administration | Prostaglandins, Synthetic | Endocrine System | Physiology | Biology | Evaluation Indexes | Quantitative Evaluation | Evaluation Document Number: 193372 Notification |
| 28. Peer Reviewed Title: Intracervical Foley catheter balloon vs. prostaglandin in preinduction cervical ripening. Author: Niromanesh S; Mosavi-Jarrahi A; Samkhaniani F Source: International Journal of Gynecology and Obstetrics. 2003 Apr;81(1):23-27. Abstract: Objectives: The aim of this study is to compare the effectiveness of the intracervical Foley balloon catheter and 3 mg prostaglandin E tablet(s) in preinduction cervical ripening. Methods: Ninety women referred to the maternity 2 clinic for induction of labor with a Bishop score of less than or equal to 5 were randomized to receive an intracervical Foley catheter or prostaglandin E2 tablets. The primary measured outcome was ripening of the cervix as measured with the Bishop score. Results: There were no differences in mean Bishop scores between the prostaglandin and the Foley catheter groups. Bishop scores (mean +/- S.D.) after ripening were 6.6 +/- 0.80 and 6.7 +/- 0.86 for the Foley catheter and prostaglandin groups, respectively (P=0.54). The Foley catheter group showed a statistically shorter time to ripening compared with the prostaglandin group (3.4 +/- 2.1 and 6.5 +/- 3.2 h, respectively (P=0.001). There was no statistically significant difference in induction time (4.8 +/- 1.8 h and 5.3 +/- 2.4 h, respectively (P=0.36). Conclusions: There are no differences in preinduction cervical ripening efficacy between prostaglandin E2 and the Foley catheter, but the Foley catheter has the advantage of ripening an unfavorable cervix in a shorter time. (author's) Language: English Keywords: IRAN | RESEARCH REPORT | COMPARATIVE STUDIES | CATHETER | PROSTAGLANDINS | CERVIX | CHILDBIRTH | Developing Countries | Middle East | Studies | Research Methodology | Equipment and Supplies | Endocrine System | Physiology | Biology | Uterus | Genitalia, Female | Genitalia | Urogenital System | Pregnancy Outcomes | Pregnancy | Reproduction Document Number: 177212 |
| 29. Title: Persistence of mucosal mast cells and eosinophils in Shigella-infected children. Author: Raqib R; Moly PK; Sarker P; Qadri F; Alam NH Source: Infection and Immunity. 2003 May;71(5):2684-2692. Abstract: Cells of the innate immune system and their mediators were studied at the single-cell level in the rectums of pediatric and adult patients with Shigella infection to better understand why children are at higher risk for severe infection. Adult patients had increased infiltration of mucosal mast cells (MMC) at the acute stage (3 to 5 days after the onset of diarrhea) and eosinophils in early convalescence (14 to 16 days after onset). Increased expression of stem cell factor and prostaglandin H synthase-1 (PGHS-1) was associated with increased tryptase-K(i)67-double-positive MMC in the acute stage and increased apoptosis of MMC, which led to a rapid decline in early convalescence. The eosinophils demonstrated increased expression of major basic protein (MBP), eotaxin, and CCR3, as well as increased necrotic death. The neutrophils showed enhanced a-defensin and lactoferrin expression in the acute phase. In contrast to adults, the pediatric patients demonstrated delayed accumulation of mast cells and eosinophils, while a-defensin expression persisted during convalescence. In contrast, neutrophil counts and lactoferrin expression were reduced in children compared to adults. The results suggest that children with shigellosis have a persistent activation of the innate immune response in the convalescent phase, indicating delayed elimination of Shigella antigens compared to adults. (author's) Language: English Keywords: BANGLADESH | RESEARCH REPORT | CLINICAL RESEARCH | GENETIC TECHNIQUES | STATISTICAL STUDIES | CASE CONTROL STUDIES | CHILD | ADULTS | IMMUNITY, CELLULAR | BACTERIAL AND FUNGAL DISEASES | DIARRHEA | GENETICS | PROSTAGLANDINS | HISTOCHEMICAL EFFECTS | TIME FACTORS | IRON | ANTIBODIES | IMMUNOLOGICAL EFFECTS | ANTIGENS | LABORATORY EXAMINATIONS AND DIAGNOSES | HISTOLOGY | Asia, Southern | Asia | Developing Countries | Research Methodology | Examinations and Diagnoses | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Immunity | Immune System | Physiology | Biology | Infections | Diseases | Endocrine System | Cytologic Effects | Population Dynamics | Metals | Vitamins and Minerals | Immunologic Factors Document Number: 188129 |
| 30. Peer Reviewed Title: PGE2 induction of labor for consistent decreased perception of fetal movements at term. Author: Yogev Y; Ben-Haroush A; Horowitz ER; Chen R; Hod M Source: International Journal of Gynecology and Obstetrics. 2003 Aug;82(2):173-178. Abstract: Objectives: To determine the effects of labor induction with vaginal prostaglandin E2 (PGE2) on mode of delivery and immediate neonatal outcome in women with consistent decreased perception of fetal movements at term. Methods: The study group consisted of 115 women with consistent perception of decreased fetal movements admitted for induction of labor at term. Findings were compared with those of 510 women with normal spontaneous onset of labor. Women with previous cesarean section (CS) were excluded from both the study and control groups. Results: The rate of CS was higher in the study group (14.8%) than in the control group (9%) (not significant). The rates of low 5-min Apgar score (F7) and CS performed for non-reassuring fetal heart rate were two-fold higher in the study group than in the control group (2.6% vs. 1.2%, and 6.1% vs. 3.1%, respectively, not significant in both). Conclusion: Induction of labor with PGE2 is successful in approximately 85% of the patients with decreased perception of fetal movements at term and apparently with no serious maternal or fetal complications. However, these pregnancies might be at higher risk of perinatal complications. We suggest that active labor induction may be currently considered as the preferred strategy in these pregnancies. Large prospective randomized studies on maternal and neonatal outcome are needed to clarify this issue. (author's) Language: English Keywords: ISRAEL | RESEARCH REPORT | CLINICAL RESEARCH | PREGNANT WOMEN | FETUS | PROSTAGLANDINS | NEONATAL DISEASES AND ABNORMALITIES | CHILDBIRTH | Middle East | Developed Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Endocrine System | Physiology | Biology | Diseases | Pregnancy Outcomes Document Number: 182292 |
 |
||
 |
Information & Knowledge for Optimal Health (INFO) Project 111 Market Place Suite 310, Baltimore, MD 21202 Phone: 410-659-6300 Fax: 410-659-6266 Security & Privacy Policy |  |