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Effect of a prostaglandin E1 analogue (gemeprost) on uterine and luteal circulation in normal first trimester pregnancies. A Doppler velocimetry study

Valentin, Lil LU ; Sladkevicius, Povilas LU ; Laurini, Ricardo LU ; Söderberg, Hanna; Olofsson, Per LU and Marsal, Karel LU (1995) In European Journal of Obstetrics, Gynecology, and Reproductive Biology 59(1). p.25-34
Abstract
OBJECTIVE: To evaluate the effects of gemeprost on utero-placental and luteal circulation and on the embryo/fetus in normal first trimester pregnancies. STUDY DESIGN: Sixty-seven women with a normal first trimester pregnancy requesting termination of pregnancy for psychosocial reasons were randomly allocated to pre-operative treatment with vaginal suppositories containing placebo or gemeprost. The women underwent transvaginal color and spectral Doppler ultrasound examination before the application of the suppository, 4 h after the application of the suppository but before the abortion, and on the seventh post-operative day. Blood flow velocities in the uterine and subchorionic arteries, the intrachorionic area and arteries in the wall of... (More)
OBJECTIVE: To evaluate the effects of gemeprost on utero-placental and luteal circulation and on the embryo/fetus in normal first trimester pregnancies. STUDY DESIGN: Sixty-seven women with a normal first trimester pregnancy requesting termination of pregnancy for psychosocial reasons were randomly allocated to pre-operative treatment with vaginal suppositories containing placebo or gemeprost. The women underwent transvaginal color and spectral Doppler ultrasound examination before the application of the suppository, 4 h after the application of the suppository but before the abortion, and on the seventh post-operative day. Blood flow velocities in the uterine and subchorionic arteries, the intrachorionic area and arteries in the wall of the corpus luteum and the embryonic/fetal heart rate were measured. RESULTS: The median value for pulsatility index (PI) in the dominant uterine artery was 2.4 before treatment with gemeprost and 8.5 4 h after treatment (P = 0.0006); the corresponding values for time-averaged maximum velocity (TAMXV) being 27 cm/s and 10 cm/s (P = 0.0006). Four (14%) of 28 embryos/fetuses in the gemeprost group were dead 4 h after treatment with gemeprost and the median heart rate of those still alive was significantly lower than before treatment (130 vs. 163 bpm; P = 0.003). In the placebo group, the results for the uterine arteries and the embryonic/fetal heart rate did not differ significantly between the first and second ultrasound examinations. The median values for PI and TAMXV in the arteries of the corpus luteum wall at the first ultrasound examination were 0.71 and 18 cm/s, respectively, in the placebo group and 0.71 and 20 cm/s, respectively, in the gemeprost group. These values remained almost unchanged at the second and third ultrasound examinations in both groups. CONCLUSION: Gemeprost has profound effects on utero-placental circulation in the first trimester and can induce embryonic/fetal bradycardia and sometimes embryonic/fetal demise. It has no unequivocal effect on luteal circulation. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Corpus luteum, Utero-placental circulation, Early pregnancy, Doppler ultrasound
in
European Journal of Obstetrics, Gynecology, and Reproductive Biology
volume
59
issue
1
pages
25 - 34
publisher
Elsevier
external identifiers
  • pmid:7781857
  • scopus:0028986949
ISSN
0301-2115
DOI
10.1016/0028-2243(94)02027-C
language
English
LU publication?
yes
id
b50e49c9-d8f8-469a-9ad0-4c8e6156f4a7 (old id 1109778)
date added to LUP
2008-07-28 16:25:19
date last changed
2017-01-01 04:24:30
@article{b50e49c9-d8f8-469a-9ad0-4c8e6156f4a7,
  abstract     = {OBJECTIVE: To evaluate the effects of gemeprost on utero-placental and luteal circulation and on the embryo/fetus in normal first trimester pregnancies. STUDY DESIGN: Sixty-seven women with a normal first trimester pregnancy requesting termination of pregnancy for psychosocial reasons were randomly allocated to pre-operative treatment with vaginal suppositories containing placebo or gemeprost. The women underwent transvaginal color and spectral Doppler ultrasound examination before the application of the suppository, 4 h after the application of the suppository but before the abortion, and on the seventh post-operative day. Blood flow velocities in the uterine and subchorionic arteries, the intrachorionic area and arteries in the wall of the corpus luteum and the embryonic/fetal heart rate were measured. RESULTS: The median value for pulsatility index (PI) in the dominant uterine artery was 2.4 before treatment with gemeprost and 8.5 4 h after treatment (P = 0.0006); the corresponding values for time-averaged maximum velocity (TAMXV) being 27 cm/s and 10 cm/s (P = 0.0006). Four (14%) of 28 embryos/fetuses in the gemeprost group were dead 4 h after treatment with gemeprost and the median heart rate of those still alive was significantly lower than before treatment (130 vs. 163 bpm; P = 0.003). In the placebo group, the results for the uterine arteries and the embryonic/fetal heart rate did not differ significantly between the first and second ultrasound examinations. The median values for PI and TAMXV in the arteries of the corpus luteum wall at the first ultrasound examination were 0.71 and 18 cm/s, respectively, in the placebo group and 0.71 and 20 cm/s, respectively, in the gemeprost group. These values remained almost unchanged at the second and third ultrasound examinations in both groups. CONCLUSION: Gemeprost has profound effects on utero-placental circulation in the first trimester and can induce embryonic/fetal bradycardia and sometimes embryonic/fetal demise. It has no unequivocal effect on luteal circulation.},
  author       = {Valentin, Lil and Sladkevicius, Povilas and Laurini, Ricardo and Söderberg, Hanna and Olofsson, Per and Marsal, Karel},
  issn         = {0301-2115},
  keyword      = {Corpus luteum,Utero-placental circulation,Early pregnancy,Doppler ultrasound},
  language     = {eng},
  number       = {1},
  pages        = {25--34},
  publisher    = {Elsevier},
  series       = {European Journal of Obstetrics, Gynecology, and Reproductive Biology},
  title        = {Effect of a prostaglandin E1 analogue (gemeprost) on uterine and luteal circulation in normal first trimester pregnancies. A Doppler velocimetry study},
  url          = {http://dx.doi.org/10.1016/0028-2243(94)02027-C},
  volume       = {59},
  year         = {1995},
}