Document Detail


Sulprostone for pregnancy termination in women with severe (pre-) eclampsia.
MedLine Citation:
PMID:  12175439     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONDENSATION: Sulprostone, used in a continuous low-dose intravenously, is effective for pregnancy termination. Caution is necessary when using this drug in severely preeclamptic patients.
OBJECTIVE: To evaluate the safety and efficacy of induction of labor with a prostaglandin analogue in women with severe (pre-) eclampsia.
STUDY DESIGN: A retrospective analysis of a 12-year cohort in which labor was induced in women with severe (pre-) eclampsia with sulprostone (a prostaglandin E2 analogue) in a continuous intravenous low-dose intravenous dose of 1 microg/min.
RESULTS: In 30 severely preeclamptic and one eclamptic women, labor was induced on maternal indication with sulprostone. The median gestational age at induction was 28 weeks (range 16-37 weeks). The fetuses were either dead (n=19) or considered not viable (n=12). All women delivered vaginally after a median induction-expulsion interval of 14 hr (range 6-57 hr). In all but one woman, a delivery was achieved within 37 hr. Two of the nine women who suffered dyspnea at the time induction was started, experienced deterioration during infusion of sulprostone. In one of these women, infusion had to be discontinued after 2 hr and the pregnancy was terminated by dilatation and evacuation. One woman gave birth after 57 hr of sulprostone infusion. We did not observe any cardiovascular complications. All but one woman recovered after pregnancy termination: a severely eclamptic woman died 10 days after delivery, after developing adult respiratory distress syndrome, sepsis and multiple organ failure.
CONCLUSION: Sulprostone, in a continuous low-dose intravenously, is effective for termination of pregnancy in the critically ill preeclamptic woman. Our study, including two patients with serious deterioration of pulmonary function during and one maternal death after induction, does not permit definitive conclusions regarding the safety in these patients.
Authors:
Nicolette van Gemund; Marjon A de Boer; Maria van Selm; Sicco A Scherjon; Humphrey H H Kanhai
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hypertension in pregnancy : official journal of the International Society for the Study of Hypertension in Pregnancy     Volume:  21     ISSN:  1064-1955     ISO Abbreviation:  Hypertens Pregnancy     Publication Date:  2002  
Date Detail:
Created Date:  2002-08-14     Completed Date:  2002-09-18     Revised Date:  2011-08-25    
Medline Journal Info:
Nlm Unique ID:  9421297     Medline TA:  Hypertens Pregnancy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  115-22     Citation Subset:  IM    
Affiliation:
Department of Obstetrics, Albinusdreef 2, 2333 ZA Leiden University Medical Center, Leiden, The Netherlands. n.van_gemund@lumc.nl
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / administration & dosage,  pharmacology*
Abortion, Spontaneous / chemically induced*
Adult
Dinoprostone / administration & dosage,  analogs & derivatives*,  pharmacology*
Female
Humans
Pre-Eclampsia* / physiopathology
Pregnancy
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 363-24-6/Dinoprostone; 60325-46-4/sulprostone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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