Vaginal and abdominal delivery increases maternal urinary 6-keto-prostaglandin F1 alpha excretion

To study the role of the antiaggregatory and vasodilatory prostacyclin (PGI2) during human delivery, serial urine samples collected from 13 women delivered vaginally and from eight delivered abdominally were assayed for 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha, a breakdown product of PGI2) by high-performance-liquid-chromatography and radioimmunoassay. In women delivered vaginally the mean urinary 6-keto-PGF1 alpha concentration was 41.9 (SE 8.3) ng/mmol creatinine, before the onset of labour and increased progressively to a maximum of 186.5 (SE 47.6) ng/mmol creatinine 2 h after delivery irrespective of the use of oxytocin and epidural analgesia. In women delivered by caesarean section under epidural anaesthesia, the urinary 6-keto-PGF1 alpha rose from 33.4 (SE 4.2) ng/mmol creatinine to 2153 (SE 314) ng/mmol creatinine 2 h after section. In both groups the increased levels had fallen by 24 h postpartum to levels below those found before delivery. In neonatal urine 6-keto-PGF1 alpha concentrations were some 12-30 times higher than those in postpartum urine. Thus, vaginal and abdominal delivery is accompanied by significant increases in maternal PGI2 release, perhaps in the myometrium and/or intrauterine tissues. This may be of significance in the regulation of fetoplacental blood flow and in the prevention of intra- and postpartum thrombosis.     

Vaginal Prostaglandin F2α Gel Before First Trimester Termination of Pregnancy

Summary: Tylose gel containing either 10 mg prostaglandin F_2α or sterile water was inserted into the posterior vaginal fornix of 130 patients either 12 hours or 4 hours before suction curettage. No benefit in terms of cervical softening or blood loss was noted in patients who received the prostaglandin gel.     

Termination of Pregnancy by Intra-uterine Prostaglandin F2α

Summary: Fourteen pregnancies between the 12th and 19th weeks of gestation were terminated by intra-uterine administration of prostaglandin F_2α. In 7 patients the method of administration was transcervically into the extra-ovular space; in the other 7, administration was directly into the amniotic sac. The methods of administration, the doses used, the side effects and results are discussed. The findings indicate that intra-amniotic administration is the procedure of choice: firstly, because of the incidence of genital tract infection after transcervical administration; secondly, because 3 patients in the transcervical group had incomplete abortions and required anaesthesia for curettage; and finally, the induction-abortion interval was significantly less when the drug was administered into the uterine cavity.     

Amniotic fluid concentrations of secreted pregnancy-associated endometrial α1 and α2-globulins (α1- and α2-PEG)

Summary. The levels of pregnancy-associated endometrial α₁- and α₂-globulins (α₁- and α₂-PEG), the two major proteins synthesized and secreted by the endometrium in vitro have been assayed in 210 amniotic fluid specimens obtained at termination of pregnancy or by amniocentesis, or at delivery. α₁-PEG was undetectable until week 10 and thereafter rose to peak levels between weeks 20 and 24. Levels fell 15-fold by week 35 but substantial amounts were still present at parturition. α₂-PEG was present at highest levels during early pregnancy, at weeks 6–15, but thereafter levels rapidly fell until during weeks 31–42 α₂-PEG was detectable in only 3 of 25 specimens. During weeks 15–20, when α₂-PEG levels fell and α₁-PEG levels rose, a high correlation was observed between the week of gestation and the log of the ratios of the concentration of these proteins. These observations provide the opportunity to assess the role of endometrial and decidual dysfunction in the aetiology of pregnancy disorders.     

Primary dysmenorrhoea: the importance of both prostaglandins E2 and F2α

Summary. Menstrual fluid was collected in a contraceptive diaphragm from 16 women with primary dysmenorrhoea and 12 matched control subjects without dysmenorrhoea. Prostaglandins F_2α (PGF_2α), E₂ (PGE₂) and 6-oxo-prostaglandin F_1α (6-oxo-PGF_lα) were extracted and measured using gas-chromatography: mass spectrometry (GC:MS). The concentrations of both PGF_2α and PGE₂ were higher on days 1 and 2 in the dysmenorrhoea group than in the control group and the concentration of PGF_2α was higher on day 1 than on day 2 in the dysmenorrhoea group. The concentrations of 6-oxo-PGF_1α (the stable metabolite of PGI₂) were low in both groups. These results confirm suggestions that PGF_2α is important in the aetiology of dysmenorrhoea and also indicate that PGE₂ may be involved.     

The Use of Prostaglandin F2α for the Induction of Mid-Trimester Abortion

Summary: Ninety-eight patients were given prostaglandin F_2α for the induction of mid-trimester abortion. In 42 the PGF_2α was administered by the extra-amniotic route and 37 aborted. A further 56 received the PGF_2α intra-amniotically and 55 aborted. Dose regimens are compared.