Arthur G. Shapiro

Prostaglandin F2α: Its effect on the corpus luteum of the menstrual cycle

Abstract Prostaglandin F2α (PGF2α) was infused into a peripheral vein of six female volunteers during the luteal phase of their cycle. At an infusion rate of 25 to 46 μg/min., no effect was observed on peripheral plasma progesterone levels and luteal phase length. Vaginal spotting was a common occurrence. It is concluded from this study that at the days and rates of infusion used, PGF2α is not luteolytic in the non-pregnant woman.

Auxiliary Pain Relief during Suction Curettage

Three groups of patients who were undergoing suction curettage with a paracervical block were studied for the effect of pain relief using an ancillary analgesic in the form of self-administered Methoxyflurane or stereophonic headphone music. The results indicated that the headphones produced less tension and anxiety and therefore, less complaint of pain than the control group. Methoxyflurane did not show any improvement in pain relief but was at times associated with an amnesic response to the procedure and less post-abortion cramping.

Extraovular prostaglandin F2α for early midtrimester abortion

Abstract Twenty patients who were 13 to 15 weeks pregnant received extraovular prostaglandin F 2 -alpha (PGF 2α ) in dosages of 3 mg. every 1 to 3 hours. Ninety-five per cent of the patients successfully aborted and 30 per cent of the patients had retained placental tissue. The mean abortion time was 17¾ and the average total dose used was 29.2 mg. The abortion time appeared to decrease with parity and had no relationship to weeks of gestation. Only one patient failed to abort after 31 hours of therapy. She required a curettage and was the only patient to develop a postabortion infection. The technique appears to compare favorably with the results of intra-amniotic PGF 2α . Extraovular prostaglandin may therefore be of particular value in inducing abortion in patients who are in the early midtrimester of pregnancy, i.e., when intra-amniotic instillation is technically infeasible.

Pituitary response to luteinizing hormone-releasing hormone after induced abortion in the first and second trimesters.

Luteinizing hormone-releasing hormone (LHRH) (100 microng) was administered subcutaneously to healthy female volunteers 2 and 4 weeks after induced abortion in the first trimester (group A) and the midtrimester (group B). Four patients were studied in each group. The response to LHRH was determined in terms of plasma LH and follicle-stimulating hormone levels. Adequate pituitary response occurred in subjects of group A at both 2 and 4 weeks. In group B pituitary unresponsiveness was found at 2 weeks which persisted to some extent at 4 weeks. These data are in accord with the pituitary unresponsiveness observed after termination of pregnancy at term and suggest that the duration of pregnancy has an influence on the development of this unresponsiveness.

Intravaginal administration of 9-deoxo-9-methylene-16,16-dimethyl PGE2 for cervical dilation prior to suction curettage

The use of prostaglandin for “priming” the cervix may avoid the pain and potential injuries associated with the rapid instrument dilation of a suction curettage. Prostaglandins appear to be able to soften and dilate the cervix, so that mechanical dilation is usually unnecessary. The results of the present study indicate that a single 16,16‐dimethyl PGE2 vaginal suppository is apparently adequate for achieving this effect as well as having relatively minimal side effects.

Intrauterine Extra-Amniotic 15(S)-15-Methyl Prostaglandin F2α for Induction of Early Midtrimester Abortion * †

Twenty-six patients 13 to 15 weeks pregnant received extraovular 15(S)-15-methyl prostaglandin F2 alpha in a dosage of 1 mg every 18 to 24 hours for three doses. Twenty-five (96%) of the patients aborted; fifteen patients aborted incompletely. The mean induction-to-abortion time was 15.8 hours. A decrease in plasma progesterone levels could not be consistently correlated with abortifacient activity, and there was no statistically significant relationship between abortion time and parity or gestational age. One patient failed to abort after 36 hours of therapy and was aborted by curettage. She was the only patient who developed a postabortion uterine infection. Results with the extraovular technique appear to be similar to those with the intra-amniotic and the intramuscular prostaglandin techniques. Therefore, extraovular administration may be useful for inducing abortion in patients who are in the early midtrimester of pregnancy.

Uterine polypoid hemangioendothelioma: Conservative treatment

A polypoid uterine hemangioendothelioma was treated by conservative means.