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Maturation of the uterine cervix by repeated intracervical instillation of prostaglandin E2

Article Abstract:

Ripening, or maturation, of the cervix is often needed when labor must be induced in high-risk pregnancies. A single application of prostaglandin E2 (PGE2), one of a group of hormones that are locally produced and act locally, is recommended in these cases. If this is not effective and uterine contractions do not begin, treatment with oxytocin is then started. If a single dose of PGE2 gel is insufficient and the cervix is inadequately dilated when labor is induced, the need for a cesarean section is likely. Repeated doses of PGE2 may be effective in such cases, but it is important to determine the effect of such treatment on the fetus in these high-risk pregnancies. The outcome of 49 deliveries occurring after a single PGE2 application was compared with the outcome of 51 pregnancies treated with repeated PGE2 applications. No side effects of treatment occurred. There was no difference between groups in the number of patients who needed induction of labor due to slowed fetal heart rate, nor were there differences in the incidence of persistent uterine contractions or improved cervical maturation. The number of patients who had spontaneous labor was also similar. The amount of cesarean sections, birth weights, and Apgar vital signs scores were comparable in the two groups. These results indicate that multiple PGE2 applications are not likely to harm the fetus as long as patients are closely monitored. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Evaluation, Obstetrical pharmacology

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Expression of bcl-2 in invasive and in situ carcinoma of the uterine cervix

Article Abstract:

The level of the protein bcl-2 gradually declines in patients with cervical cancer and these patients have a poor prognosis. The bcl-2 protein inhibits cell death. Researchers measured bcl-2 in cervical tissue samples from 22 women with localized ovarian cancer and 137 with invasive cervical cancer. The protein was found in 82% of the samples from women with localized cancer but in only 61% of those with invasive cancer. Seventy-four percent of those with bcl-2 in their tumors were alive five years later, compared to only 18% of those with no bcl-2 in their tumors.

Prognosis, Cervical cancer, Oncogenes

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The action of prostaglandin E2 on the human cervix: stimulation of interleukin 8 and inhibition of secretory leukocyte protease inhibitor

Article Abstract:

Prostaglandin E2 may induce cervical ripening by stimulating the production of interleukin-8 and inhibiting the production of secretory leukocyte protease inhibitor. Cervical ripening is the term for the softening of the cervix during labor so the baby can pass through the birth canal.

Physiological aspects, Labor (Obstetrics)

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