CONVULSIONS AND PROSTAGLANDIN-INDUCED ABORTION
CONVULSIONS AND PROSTAGLANDIN-INDUCED ABORTION
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惊厥和前列腺素引起的流产
DOI：
10.1016/s0140-6736(73)92895-x
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发表时间：
1973
期刊：
影响因子：
--
通讯作者：
M. Embrey
中科院分区：
文献类型：
--
作者：
I. Mackenzie;K. Hillier;M. Embrey
PIP：牛津大学在三年的时间里进行了615例终止妊娠手术，使用前列腺素作为主要的人工流产剂；50%的病例使用了静脉输注催产素。给药途径和给药方案有羊膜内给药、羊膜外给药和静脉给药。7例患者有癫痫发作史，入院终止时正在接受抗惊厥治疗；在流产过程中继续进行。这些患者中有1人在入院后(但在治疗前)和流产后发作，但615名患者在服用前列腺素期间均未出现抽搐。癫痫组6例羊膜外注射前列腺素E_2，7例羊膜内注射前列腺素E_2。流产发生在7小时至35小时半之间。世界卫生组织的一份报告引用了在两个大学中心进行的试验，这些试验涉及123名接受羊膜内前列腺素F2α治疗的患者和126名接受羊膜内高渗盐水治疗的患者，这些患者被随机分配到治疗中。每组中均有1名患者出现惊厥：其既往病史未被记录。Lyneham等人报道的惊厥。发生在滴注前列腺素后7-30小时，这可能排除了意外全身给药的可能性，但这可能表明参与了循环代谢物或由流产过程触发的内源性产物。
PIP: 615 terminations of pregnancy have been performed in Oxford over a 3-year period with prostaglandins as the prime abortifacient agent; an intravenous infusion of oxytocin was used in 50% of cases. The routes of administration and dose regimen were intraamniotic, extraamniotic, and intravenous. 7 patients had a history of epileptic seizures and were receiving anticonvulsant therapy at the time of admission for termination; this was continued during the abortion procedure. 1 of these patients had fits after admission (but before therapy) and after abortion, but none of the 615 patients had convulsions during the administration of the prostaglandins. 6 of the epileptic group received PGE2 extraamniotically, and the 7th patient PGE2 intraamniotically. Abortion occurred between 7 and 35-1/2 hours. A WHO report quotes trials in 2 university centers of 123 patients treated with intraamniotic PGF2 alpha and 126 patients given intraamniotic hypertonic saline assigned to treatment by random allocation. Convulsions occurred in 1 patient in each group: their previous history is unrecorded. The convulsions reported by Lyneham et al. occurred 7-30 hours after instillation of prostaglandins, which probably precludes the possibility of accidental systemic administration, but which may suggest the involvement of circulating metabolites or endogenous production triggered by abortion processes.