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[孕早期局部应用前列腺素诱导流产时的血浆激素浓度]

[Plasma hormone concentrations in induced abortion with local prostaglandin administration in the 1st trimester].

作者信息

Rath W, König A, Ulbrich R, Hilgers R, Kuske R, Kuhn W

出版信息

Zentralbl Gynakol. 1983;105(15):961-71.

PMID:6578640
Abstract

Abortion was performed by curettage on 71 women with pregnancies between the 7th and the 13th week of gestation seven to eight hours after intracervical application of a tylose gel containing 3mg prostaglandin F2 alpha. Prior to the application of the prostaglandin and immediately before the surgical intervention a sonographic examination for determining the vitality of the pregnancy was carried out.--Plasma progesteron, estradiol and HPL levels were determined radioimmunologically prior to the application of prostaglandin, at four-hour intervals on the day of intervention, and 24, 48 and 72 hours after the intervention. In 22 women a complete or an incomplete abortion occurred; in two cases a blighted ovum was observed; 47 pregnancies, according to sonographic examination, remained intact until curettage. After seven to eight hours duration of the effect of the prostaglandin gel, progesterone levels were found to be reduced to 60.5 per cent and 17-beta-estradiol to 31.4 per cent of the initial values, whereas the HPL values fell below the specificity of the testing procedure (12.5 ng/ml). Comparative investigations of the pregnancies which, according to sonographic findings, remained intact until curettage and those which were aborted after the application of prostaglandin did not, in spite of low plasma progesterone and estradiol levels in the abortive group, reveal any statistically significant differences. The abortive effect--even with local application--of the prostaglandins was confirmed. Conclusions regarding the effective mechanism of the prostaglandins upon the fetoplacental unit and the function of the corpus luteum remain subject to speculation.

摘要

对71名妊娠7至13周的妇女,在宫颈内应用含3mg前列腺素F2α的泰洛糖凝胶7至8小时后,通过刮宫术进行流产。在应用前列腺素之前以及手术干预前立即进行超声检查以确定妊娠的活力。——在应用前列腺素之前、干预当天每隔4小时以及干预后24、48和72小时,通过放射免疫法测定血浆孕酮、雌二醇和人胎盘催乳素水平。22名妇女发生了完全或不完全流产;2例观察到枯萎卵;根据超声检查,47例妊娠在刮宫前保持完整。在前列腺素凝胶作用7至8小时后,发现孕酮水平降至初始值的60.5%,17-β-雌二醇降至31.4%,而人胎盘催乳素值低于检测方法的特异性(12.5 ng/ml)。对根据超声检查结果在刮宫前保持完整的妊娠与应用前列腺素后流产的妊娠进行的比较研究,尽管流产组血浆孕酮和雌二醇水平较低,但未发现任何统计学上的显著差异。前列腺素的流产作用——即使是局部应用——得到了证实。关于前列腺素对胎儿-胎盘单位和黄体功能的作用机制的结论仍有待推测。

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