No abortion-inducing effect of the ulcer-healing dose of the synthetic prostaglandin E2 analogue enprostil in first trimester.
Milligram-range doses of E2 prostaglandins have long been used to induce labor or abortion in the second and third trimesters of pregnancy. Enprostil, a synthetic dehydroprostaglandin E2 structural analogue, is administered in microgram doses for the treatment of acute duodenal ulcer and acute gastric ulcer. This study examined the effect of the ulcer-healing dose and twice the ulcer-healing dose upon women in the first trimester of pregnancy. Two hundred and seven women who had requested legal abortion in the first trimester participated in two randomized, double-blind, placebo-controlled, parallel studies. They received two doses of enprostil 35 micrograms (the recommended dose for the treatment of duodenal and gastric ulcer) (n = 51), 70 micrograms (twice the recommended dose) (n = 53), or placebo (n = 103) 12 h apart. No drug-induced abortions occurred in any of the first-trimester pregnancies. Vaginal bleeding occurred in 4% of volunteers receiving the lower dose and 4% receiving the higher dose of enprostil. Vaginal bleeding occurred in up to 2% of volunteers on placebo. Although not recommended for pregnant women, if enprostil is given inadvertently to pregnant women with ulcers, it is unlikely to endanger the pregnancy during the first trimester.
Jacobson
J
J
Department of Obstetrics and Gynecology of Södertälji Skukhus, Sweden.
Bergquist
C
C
Rydnert
J
J
Bokström
H
H
Huovinen
K
K
D000019:Abortifacient Agents; D000028:Abortion, Induced; D000328:Adult; D004311:Double-Blind Method; D016620:Enprostil; D005260:Female; D006801:Humans; D010437:Peptic Ulcer / Q000188:drug therapy; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011459:Prostaglandins E, Synthetic / Q000008:administration & dosage / Q000627:therapeutic use / Q000633:toxicity*; D016032:Randomized Controlled Trials as Topic
D000019:Abortifacient Agents; D011459:Prostaglandins E, Synthetic; D016620:Enprostil