Medical approaches to termination of early pregnancy.

Abstract:

:Termination of early pregnancy by vacuum aspiration is a well-established technique. The procedure is highly effective and has a low complication rate, particularly when performed during the first few weeks after missed menses. However, this parasurgical method requires skilled health care personnel, and attempts have therefore been made to find medical alternatives. Prostaglandins were the first agents to be used successfully for this purpose, but the high incidence of mainly gastrointestinal side-effects has limited their widespread use. More recently, attention has focused on antiprogestational steroids, i.e., compounds that prevent the action of progesterone either by inhibiting its biosynthesis or by preventing it from binding to the cellular receptors in target organs. Current experience indicates that these compounds, particularly when used in combination with a low dose of a synthetic prostaglandin analogue, have the potential to become a safe, effective, and acceptable medical method for the termination of early pregnancy. :Vacuum aspiration is considered a very effective manner to terminate early pregnancies. This procedure carries a low rate of complications, particularly during the 1st few weeks after missed menses; however, it requires skilled health personnel. 2 methods have been developed as medical alternatives to vacuum aspiration: use of prostaglandins (PGs) and/or antiprogestational agents. Attention was focused on the use of PGs as a method of early termination of pregnancy because of their ability to stimulate uterine contraction. However, the use of PGs are also accompanied by frequent occurrences of gastrointestinal side effects and severe abdominal cramps. Despite these side effects, there is the possibility of reducing the dosage, thus reducing the side effects to little or nothing. Antiprogestational agents work to inhibit biosynthesis and also block the effect of progesterone on target cells. Administration of a low dosage progestin analogue in addition to the PG has prove to be a medically feasible approach to the early termination of a pregnancy.

authors

Van Look PF,Bygdeman M

subject

Has Abstract

pub_date

1989-01-01 00:00:00

pages

567-75

issue

5

eissn

0042-9686

issn

1564-0604

journal_volume

67

pub_type

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