RESUMO
The influence of purified porcine relaxin on contractility of human cervical smooth muscle was investigated in vitro. Strips of cervical tissue were obtained by needle biopsy from pregnant and nonpregnant women and were mounted in a superfused organ chamber for isometric measurement of contractile activity. Relaxin (0.005-25 micrograms/ml) inhibited the spontaneous contractions in cervical strips from 18% of nonpregnant, 68% of early pregnant, and in 100% of term pregnant women. These results indicate that relaxin has an inhibitory action on cervical smooth muscle and that this effect is more constantly detected as pregnancy proceeds.
Assuntos
Colo do Útero/efeitos dos fármacos , Músculo Liso/efeitos dos fármacos , Relaxina/farmacologia , Animais , Feminino , Idade Gestacional , Humanos , Técnicas In Vitro , Contração Muscular/efeitos dos fármacos , Gravidez , SuínosRESUMO
A new gel for local application of prostaglandins has been elaborated. The new gel, based on a lyophilized prostaglandin E2 (PGE2) starch powder, seems to have solved most of the pharmaceutical and clinical problems associated with local administration of prostaglandins. In a randomized double-blind study, 50 nulliparous patients with an unfavorable cervical state at term were given 2 ml gel containing 0.5 mg PGE2 (PGE2 gel) or gel without PGE2 (placebo gel). The gel was deposited into the cervical canal. Among patients given PGE2 gel, 11 of 25 had induced labor, delivering without further stimulation within 24 hours. In patients given placebo gel, 2 of 25 were delivered with 24 hours. This difference is statistically significant (P less than .01). Patients undelivered after treatment with PGE2 gel achieved a considerable and statistically significant improvement of cervical score, whereas in patients in whom labor was not induced successfully by placebo gel treatment no significant changes in cervical score were registered. In a subsequent open study another 70 term patients of varied parity were given 0.5 mg PGE2 gel. Thirty-eight patients (54%) had successfully induced labor. Among the remaining undelivered patients, considerable ripening of the cervix occurred. Thus, the cervical score changed from a mean of 3.2 prior to treatment to a mean of 6.5 by 24 hours after treatment. Gastrointestinal discomforts were not observed. Signs of uterine hyperstimulation were registered in 1 patient.
Assuntos
Trabalho de Parto Induzido/métodos , Prostaglandinas E/administração & dosagem , Adolescente , Adulto , Colo do Útero/efeitos dos fármacos , Ensaios Clínicos como Assunto , Dinoprostona , Método Duplo-Cego , Feminino , Géis , Humanos , Primeira Fase do Trabalho de Parto , Gravidez , Distribuição AleatóriaRESUMO
PIP: Vaginal suppositories containing 15(S)15-methyl-PGF2alpha-methyl ester (prostaglandin, PG) were tested for legal abortion of pregnancies (36-60 days after last menstrual period) in 42 women; 4 suppositories each containing 1 or 1.5 mg of PG were given every 3 hours. Serum levels of human chorionic gonadotropin (HCG), estradiol-17 beta, and progesterone were measured before and up to 3 weeks after the abortion. Blood loss during, after, and during a menstrual period 2-4 months after the abortion (in 30 women) was determined. Abortion without retention of major products of conception occurred in 93% of the cases. However, 18% of these successful cases had a slow decline in HCG, indicating incomplete expulsion of viable chorionic tissue. Average blood loss was 37 ml during the 1st 24 hours after insertion, with an additional loss of 94 ml in the next 11 days (range, 5-25 days). Heavy blood loss after abortion was significantly related to slow decline in serum HCG. Later menstrual flow was strikingly heavy overall (mean, 74 ml). There was no difference in efficacy or incidence of slow HCG decline between the PG dose of 1 mg and 1.5 mg, but side effects of uterine pain, vomiting, and diarrhea (50% overall, in no case severe) were more marked with the 1.5-mg dose.^ieng