INDUCTION OF LABOR WITH INTRAVAGINAL MISOPROSTOL IN INTRAUTERINE FETAL DEATH

OBJECTIVE: Our purpose was to evaluate the effectiveness and safety of intravaginal misoprostol for the induction of labor in intrauterine fetal death. STUDY DESIGN: Seventy-two women at 18 to 40 weeks of pregnancy with intrauterine fetal death, without abdominal scars, were treated with 100 mu g of intravaginal misoprostol. The dose was repeated every 12 hours until effective uterine contractions and cervical dilatation were obtained, for up to 48 hours. RESULTS: The mean time from induction to delivery was 12.6 hours, and only six patients (8%) required between 24 and 48 hours, at the end of which all patients had been delivered. Only the Bishop's score was significantly associated with time from first dose to expulsion. No surgical procedure was required. Hypercontractility, sweating, fever, diarrhea, or other gastrointestinal effects were not detected. There was no need for analgesics. CONCLUSIONS: Intravaginal misoprostol at the dose of 100 mu g every 12 hours appears to be a safe, effective, practical, and inexpensive new method for induction of labor in intrauterine fetal death.171253854

Integration of carbon dioxide and hydrogen supply chains

In this work, the impact of Carbon Capture, Utilization, and Storage (CCUS) as a potential technology to reduce Germany's carbon dioxide (CO2) emissions is studied. Carbon dioxide is used as a raw material for methanol production in the global market. Carbon dioxide is captured from power plants and can be reacted to methanol with renewable hydrogen. The study shows that the integration of hydrogen- and carbon dioxide supply chains is only feasible if the electricity needed for renewable hydrogen can be delivered for free

LOW-DOSE VAGINAL MISOPROSTOL FOR INDUCTION OF LABOR WITH A LIVE FETUS

Objective: To test the effectiveness and safety of low-dose vaginal misoprostol for induction of labor with a live fetus. Methods: Labor was induced in 666 pregnant women with a live fetus in the cephalic position, who had no medical complications and no history of uterine surgery. One-fourth of a 200-mu g tablet of misoprostol (50 mu g) was placed in the posterior vaginal fornix every 12 h for a maximum of four doses or until active labor commenced. Time from induction to delivery, side effects and neonatal outcome were evaluated. Results: Labor was successfully induced in all cases. The mean time from induction to delivery was 10.4 h. The cesarean section rate was 7.8%. There were eight perinatal deaths, six of which occurred in low birth weight fetuses. There was one case of abruptio placenta, which was less than that expected in the study population. Conclusion: Vaginal misoprostol, in very low doses, was a remarkably efficient and safe method for induction of labor with a live fetus.49214915

Evaluation of the effectiveness of vaginal misoprostol to induce first trimester abortion

Two doses, 200 and 400 mu g, of misoprostol, administered vaginally every 12 hours, up to four times, were tested in 101 and 133 healthy women, respectively, for interruption of pregnancies with 35 through 77 days of amenorrhea. The proportion of women who aborted increased with longer duration of treatment and was significantly higher with 400 than with 200 mu g (66 versus 46 percent at 48 hours). Significance was maintained after controlling by age, body weight, parity, previous abortion and gestational age. Abortions were classified as incomplete or complete, according to the presence or not of embryonic tissue in the uterine cavity, diagnosed by Vaginal sonography. Vacuum aspiration was carried out in all cases not classified as complete abortion 48 hours after the initiation of treatment, or earlier in case of persistent bleeding or woman's request. The possibility of increasing effectiveness by using higher dose, shorter intervals or longer duration of treatment is discussed.53424324

Comparison Of Women Having Clandestine And Hospital Abortions: Maputo, Mozambique

In Mozambique a Ministry of Health decree since 1981 allows public hospitals to carry out abortions if pregnancy results from contraceptive failure or places a woman's health or life at risk. As a result, the number of hospital abortions has increased and the number of women attending hospital for complications of clandestine abortion has decreased. Nevertheless, clandestine abortions continue to cause maternal deaths and morbidity. This study compared women attending the main hospital in Maputo for complications of clandestine abortion and those having an induced abortion in the hospital. Most of those in the first group were young and primigravida, had experienced fewer abortions and lived in poorer socio-economic conditions. Fewer had a steady partner, were more frequently recent migrants to Maputo, and had lower knowledge and use of contraceptives. To reduce the number of illegal abortions and their consequences, governmental programmes should aim to make contraceptive and abortion services more available and accessible, particularly to young, unmarried women of low socio-economic status.59108115Ladipo, O.A., Preventing and managing complications of induced abortion in Third World countries (1989) International Journal of Gynecology and Obstetrics., (3 SUPPL.), pp. 21-28Megafu, U.B., Ozumba, B.C., Morbidity and mortality from induced illegal abortion at the University of Nigeria Teaching Hospital, Enugu: A five year review (1991) International Journal of Gynecology and Obstetrics, 34, pp. 163-167Adewole, I.F., Trends in post-abortal mortality and morbidity in Ibadan, Nigeria (1992) International Journal of Gynecology and Obstetrics, 38, pp. 115-118Rogo, K., Induced abortion in Africa (1990) Annual Meeting of the Population Association of America, , TorontoPaxman, J.M., Rizo, A., Brown, L., The clandestine epidemic: The practice of unsafe abortion in Latin America (1993) Studies in Family Planning, 24, pp. 205-226Tietze, C., Henshaw, S., (1986) Induced Abortion: A World Review. 6th Edition, , Alan Guttmacher Institute, New YorkPotts, M., Wood, C., (1972) Introduction of New Concepts in Contraception, , University Park Press, BaltimoreHord, C., David, H.P., Donnay, F., Reproductive health in Romania: Reversing the Ceausescu legacy (1991) Studies in Family Planning, 22, pp. 231-240Stephenson, P., Wagner, M., Badea, M., Commentary: The public health consequences of restricted induced abortion - Lessons from Romania (1992) American Journal of Public Health, 82, pp. 1328-1331Faúndes, A., Bedone, A., Pinto E Silva, J.L., I Forum Interprofessional para Implementação do Atendimento ao Aborto Previsto na Lei. Relatorio Final (1997) Femina, 25 (1), pp. 69-78Khan, M.L., Barge, S., Phylip, B., Abortion in India - An overview (1996) Sociocultural and Political Aspects of Abortion from An Anthropological Perspective. IUSSP Seminar, , Trivandrum, 25-28 MarchAkhter, H.H., Rider, R.V., Menstrual regulation and contraception in Bangladesh: Competing or complementary? (1984) International Journal of Gynecology and Obstetrics, 22, pp. 137-143Kabir, S.M., Causes and consequences of unwanted pregnancy from an Asian woman's perspective (1989) International Journal of Gynecology and Obstetrics, (3 SUPPL.), pp. 9-14Castle, M.A., Ukwa, R., Whittaker, M., Observations on abortion in Zambia (1990) Studies in Family Planning, 21, pp. 231-235Machungo, F., Bugalho, A., Granja, A., Mortalidade Materna No Departamento de Obstetrícia e Ginecologia Do HCM, 1990-1994, , Unpublished dataOnionka, Z., Opening address (1978) A Strategy for Abortion Management: Report of An African Regional Workshop, , IPPF, LondonnotenotenoteSundstrom, K., Abortion across social and cultural borders (1994) Sociocultural and Political Aspects of Abortion from An Anthropological Perspective. IUSSP Seminar, , Trivandrum, 25-28 MarchBugalho, A.M.A., (1994) Perfil Epidemiológico, Complicação e Custo Do Aborto Clandestino, Comparação Com Aborto Hospitalar e Parto, Em Maputo, Mozambique, , PhD dissertation. Universidade Estadual de Campinas, CampinasLema, V.M., Kamau, R., Rogo, K., (1989) Epidemiology of Abortion in Kenya, , Center for the Study of Adolescence, Nairob