Uses of prostaglandins:
For first trimester(upto 12 weeks) abortions:
For first trimester abortion prostaglandins can be used in combination.
That is with mifepristone.
-Mifepristone 600mg orally, followed by a misoprostol 800 micro g vaginally a day later. Or mifepristone 600 mg followed by 400 micro g of misoprostol orally can be used. Or lower dose mifepristone 200 mg followed by 800micro g of misoprostol , 24 to 72 hrs later vaginally can also be used.
-Repeated doses of misoprostol can be used for delayed expulsions.
-Other regimes are Tomoxifen 20 mg daily for 4 days followed by misoprostol 800 micro g vaginally, second dose 24 hrs later if needed.
-Or Methotrexate 25 to 50 mg orally or 75 mg IM, followed by 800 micro g vaginally after a week.
-Misoprostol 800 micro g daily for 3 days can be used in late first trimester.
-In very early gestation single vaginal dose of 800 micro g, or multiple doses within 24 hrs are enough.
Infants born to mothers exposed to misoprostol, may have abnormal vascular development, mobius's syndrome, congenital facial paralysis with or without limb defects, equinovarus, arthogryposis etc.
Women with medical abortions experience more bleeding and cramping than spontaneous abortions.
For second trimister(12 to 20 weeks) abortions:
PGE2 (dinoprostone) can be used in the form of 20 mg suppositories kept in the post vaginal fornix.
Side effects:
nausea, vomiting, fever, diarrhea etc. Or PGE1 ( misoprostol) can be used 600 micro g vaginally followed by 400 micro g every 4 hrly.
But even after usage of prostaglandins, 2% of women may require curettage for retained placenta.
Prostaglandins-types
Prostaglandin-routes of administration
Prostaglandins-induction of labor
Cervidril, misoprostol
Prostaglandins- in PPH, uterine atony
For first trimester(upto 12 weeks) abortions:
For first trimester abortion prostaglandins can be used in combination.
That is with mifepristone.
-Mifepristone 600mg orally, followed by a misoprostol 800 micro g vaginally a day later. Or mifepristone 600 mg followed by 400 micro g of misoprostol orally can be used. Or lower dose mifepristone 200 mg followed by 800micro g of misoprostol , 24 to 72 hrs later vaginally can also be used.
-Repeated doses of misoprostol can be used for delayed expulsions.
-Other regimes are Tomoxifen 20 mg daily for 4 days followed by misoprostol 800 micro g vaginally, second dose 24 hrs later if needed.
-Or Methotrexate 25 to 50 mg orally or 75 mg IM, followed by 800 micro g vaginally after a week.
-Misoprostol 800 micro g daily for 3 days can be used in late first trimester.
-In very early gestation single vaginal dose of 800 micro g, or multiple doses within 24 hrs are enough.
Infants born to mothers exposed to misoprostol, may have abnormal vascular development, mobius's syndrome, congenital facial paralysis with or without limb defects, equinovarus, arthogryposis etc.
Women with medical abortions experience more bleeding and cramping than spontaneous abortions.
For second trimister(12 to 20 weeks) abortions:
PGE2 (dinoprostone) can be used in the form of 20 mg suppositories kept in the post vaginal fornix.
Side effects:
nausea, vomiting, fever, diarrhea etc. Or PGE1 ( misoprostol) can be used 600 micro g vaginally followed by 400 micro g every 4 hrly.
But even after usage of prostaglandins, 2% of women may require curettage for retained placenta.
Prostaglandins-types
Prostaglandin-routes of administration
Prostaglandins-induction of labor
Cervidril, misoprostol
Prostaglandins- in PPH, uterine atony
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