Mid-trimester Pregnancy Research Articles

The effect of adrenocorticotropic hormone and dexamethasone, administered to the fetus in utero, upon maternal and fetal estrogens

Changes in maternal urinary estrogens and estrogen levels in maternal peripheral plasma and in umbilical plasma were studied after administration of adrenocorticotropic hormone (ACTH) or dexamethasone directly into the fetus or in the amniotic cavity during the mid-trimester of pregnancy. Estrogens in urine and umbilical plasma increased significantly following ACTH administration. After dexamethasone administration, urinary estrogens markedly decreased. These findings suggest that the estrogen production in pregnancy is regulated by fetal adrenal function.

Prostaglandin-oxytocin enhancement.

Dr. Arnold Gillespie (January 15, p.150) indicates that uterine contractions can be enhanced if oxytocin is given after previous exposure to prostaglandin E2 (PGE2). Brummer showed by in vitro experiments that after exposure to the PGE2, but not to the PGF2alpha, human myometrial strips exhibited an enhanced response to oxytocin. We report here preliminary results on the abortifacient effect of a combined treatment with PGF2alpha and oxytocin. The combined treatment, administered extraamniotically by means of a Foley catheter introduced between the fetal membranes and the uterine wall through the cervical canal, was given to 32 women admitted to the hospital for termination of midtrimester pregnancies. A dose of 0.5 mg PGF2alpha (Astra) was given hourly to 20 women. Higher doses (0.75-2.0 mg) were used if the uterine contractions were weak or lacking. 9 women received a mixture containing 0.5 mg of PGF2alpha and 1 I.U. of oxytocin, and 3 women received 3 I.U. of oxytocin alone. In the PGF2 alpha group of 20 patients, abortion was complete in 7 and incomplete in 10 cases. 3 failures were encountered. The trial was considered a failure if uterine contractions stopped in spite of continuous and increased dosage. In the group of 9 women who received a mixture of PGF2alpha and oxytocin, there was no failure. Abortion was complete in 5 and incomplete in 4 cases. Of the 3 women who received oxytocin only, 1 aborted and 2 failed. Uterine contractions were present in all 3 cases. The mean dose of PGF2alpha required for an abortion was 26.1 mg in the PG group, while that in the combined PGF2alpha and oxytocin group was 15.2 mg. 2 of 3 failures in the PG group were successfully treated with an intravenous oxytocin infusion (5 I.U./hour), which caused uterine contractions when PG had no further effect. Hysterotomy was needed in 1 case, where a bicornuate uterus was found at the operation. Extraamniotic oxytocin alone caused uterine contractions in all 3 cases included in the trial, although abortion was achieved in only 1 case. The 2 failures in the oxytocin group were treated with extraamniotic PG. In the total series of 32 cases, hysterotomy was not required in 31 (97%) if both PG and oxytocin were used. PGF2alpha and oxytocin have a contractile effect on the uterus in vivo during midtrimester. Whether the effects of these 2 drugs are additive or potentiative is now being studied.

The oxytocic effect of acridine dyes and their use in terminating mid-trimester pregnancies.

SummaryThe oxytocic effect of an acridine dye, aminacrine hydrochloride, has been investigated on isolated strips of myometrium from pregnant and non‐pregnant human uteri. Contractions were induced when the muscle strips were perfused with an aqueous solution of aminacrine at a concentration of 10–5–10–4M. 50 ml. of an 0.1 per cent solution of aminacrine was introduced into the extra‐amniotic space in 23 women in order to induce therapeutic abortion in the mid‐trimester. All the patients aborted after a mean induction delivery interval of 59 hours. Most patients required a pitocin infusion to complete the abortion. The incidence of side effects and infection was minimal. The plasma and urinary levels of the dye were measured and found to be very low.It is concluded that the extra‐amniotic injection of aminacrine is a safe, easy and effective method of terminating mid‐trimester pregnancies.

The oxytocic effect of acridine dyes and their use in the termination of mid-trimester pregnancies

The oxytocic effect of acridine dyes and their use in the termination of mid-trimester pregnancies

Effect of Increased Uterine Volume Uterine Activity During Normal on Midtrimester Pregnancy

Effect of Increased Uterine Volume Uterine Activity During Normal on Midtrimester Pregnancy

Acute Renal Failure after Therapeutic Abortion by Intra-Amniotic Saline Administration

INTRA-AMNIOTIC instillation of hypertonic saline solution has been heralded as a simple and effective means of producing abortion during the mid-trimester of pregnancy.1 2 3 In the following case a...

Bleeding in the midtrimester of pregnancy

Bleeding in the midtrimester of pregnancy

Termination of missed abortion and the induction of labor in midtrimester pregnancy

We have confirmed earlier observations, made in laboratory animals and women, that the intra-amniotic injection of hypertonic solution at any time during pregnancy will induce uterine activity terminating in evacuation of the uterus. Our studies were made in 12 patients, 6 with living, midtrimester pregnancies being therapeutically aborted on psychiatric grounds, while 6 had fetal death in utero. The average latent period before abortion or labor commenced was 21.3 hours in the former group of patients, and 14.3 hours in the latter group. All pregnancies terminated spontaneously without the necessity for pharmacologic stimulation. In 6 patients we recorded the intra-amniotic pressure before and after the injection of hypertonic saline and observed the progressive evolution of uterine activity.We believe that this is the first report describing a reliable, safe medical method of terminating missed abortion at any stage of pregnancy.

Concentrated oxytocin solution for therapeutic interruption of midtrimester pregnancy. A preliminary report.

Concentrated oxytocin solution for therapeutic interruption of midtrimester pregnancy. A preliminary report.