Clinical applications of prostaglandins in Obstetrics and Gynaecology
Karim, S.M.
Annals of the Academy of Medicine Singapore 11(4): 493-502
1982
ISSN/ISBN: 0304-4602 PMID: 6299163 Document Number: 575457
Although a number of potential practical uses of prostaglandins (PGs) have been identified, these compounds have thus far found clinical applications mainly in the areas of obstetrics and gynecology. It is almost 15 years since the 1st PG was used to induce term labor and PGE2 is now commercially available for this purpose in many countries. For the termination of 2nd trimester pregnancy, PGs have almost completely replaced other methods previously used. Other areas in which PGs are routinely used or where their use is being developed include menstrual induction, preevacuation dilatation of the cervix in the 1st trimester, termination of pregnancy in missed abortion, intrauterine fetal death and other types of abnormal pregnancies, control of postpartum hemorrhage, treatment of postpartum or postsurgical urine retention, and ripening of the cervix prior to the induction of labor at term. In early studies, PGE2 and PGF2alpha were used for all the applications mentioned above. In order to increase efficacy and reduce side effects, a number of synthetic analogues were later evaluated for application in selected areas. Those with modification in the 15 and 16 positions of PGE2 and PGF2alpha molecules have undergone extensive clinical trials and some of them are now used routinely. The current status of the practical application of PGs in obstetrics and gynecology is reviewed.