Index

abortifacients 77, 109, 124 15-methyl-PGFla 247, 275 , failed 294 p-mimetics 208, 209 prostaglandin 295 NSAIDS 124,325, 326, 375 abortion, missed oxytocin 170, 178,239,240 dilatation and evacuation 259 16-phenoxy-PGE2 methyl sulphonylamide prostaglandin use 259, 260 284 route and dose 263 PG analogues and abnormal 265 abortion, therapeutic 155,417,418 PGE2, vaginal 291 abdominal pregnancy, methods 255, 256 PGFla 72, 297 antidiarrhoea, premedication 295, 296 PGI 2 356, 357 cervical priming 278-88 prostaglandins and cervical ripening 160 complications of prostaglandin 296-300 prostaglandins and labour induction 173-6, extra-amniotic PGE2 156 190, 191 hazards 127, 128,279 intravenous 174, 178 intra-amniotic prostaglandins and saline local PGE2 189, 190 289,290 oral PGE2 181, 182, 184, 186 intra-uterine instillation 290, 291 PGFla 179-81 laminaria tents 278, 279, 285 prostaglandin synthesis inhibitors 331 live birth 298 saline 255 midtrimester and dilatation and evacuation systemic prostaglandins 154, 155 294,295 alcohol (ethyl alcohol) mortality and methods 299 fetal effects 205 mortality and morbidity 288 hormonal effects 204 prostaglandins used 271, 272 and oxytocin release 204 analogues 275-8, 291-5 passage 205 availability 272 tocolysis 204, 205 first trimester 272-88 amnion, arachidonic acid conversion 68 midtrimester 288-95 amnionitis 268 natural, vaginal delivety 274 , prostaglandin content 67, 339- second trimester 295-300 41,343 vaginal suppositories 276 in hypertension 346 second trimester management 295-300 amniotic membranes vaccuum aspiration 276 prostaglandin metabolism 253, 254, 339 adrenal cortex, prostaglandin effects 73 role in pregnancy 45 adrenaline, myometrial 74 amniotomy 159 adverse reactions abnormal pregnancy 256 cervical priming 279, 280, 286 labour induction 169, 185 induced abortion and prostaglandin dose, and oxytocin 192 274,295 risks 169 route 290 AMP, cyclic; implantation effects 122 intravenous prostaglandins 264 ampullary-isthmic junction (AI]) 83 laminaria 278, 279, 286 arachidonic acid response 89, 90 magnesium sulphate 205, 218 copper and PGFla effects 91, 93 422 INDEX

AIJ - continued morbidity 149 prostaglandin and ETYA effects 88-90 risk factors 152 structure 84 calcium antagonists, dysmenorrhoea 326, 327 analogue development 7-9; see also individual ~alcium entry blockers analogues and prostaglandins cardioprotection 206 analogues tocolysis 206 abnormal pregnancy 257, 262 calcium, sperm effects 135, 137 enzymic attack 22 Cardiff infusion pump 177 first trimester abortion 275-8 catheter half-lives and activity 22, 23 extra-amniotic prostaglandin 156, 157 blood levels 23 multichannelled microtransducer 46 structures 22 central nervous system, prostaglandin produc• anencephaly 254 tion 372, 373 delivery 266 Cervagem, therapeutic abortion 272 prostaglandin therapy 260 cervical canal routes and doses 261, 262 physiology 31, 32 termination 255 secretory cells 31 angiotensin II cervical dilatation menstrual cycle changes 343 monitoring 47 pregnancy-induced hypertension 348 probe 48 uterine blood flow 350 and ripeness 147 Apgar score, induced labour 149 cervical fistulae 296 arachidonic acid cervical incompetence 46 bioconversion scheme 13, 15 spontaneous abortion 148 cascade 3, 4 cervical mucus conversion, uterine tissues 68 composition 31, 32 decidualization 118 molecular arrangements 32 fetal membrane 69 cervical priming see also cervical ripening formation 4 administer-procedure time 287 glucorticoid effects 10 blood loss, induced abortion 287 metabolism and postpartum haemostasis 236 laminaria 285 rate limiting, prostaglandin synthesis 113 ptostaglandin analogues 281-8 structure 15 15-methyl-PGFla 281-4 , prostaglandin supple• side-effects 285, 286 ment 134, 135 vaginal suppository 283, 284 aspirin prostaglandin effects 279, 280, 411 and cyclo-oxygenase 18 cervical resistance 48 dysmenorrhoea 324, 325, 330 myometrial activity 49 follicular rupture 101, 102 cervical ripening 33,145-61,411 gestation length 76 clinical importance 151, 152 neonatal bleeding 217 flow diagram 159 neonatal effects 217 and induction 167, 168 prostaglandin metabolism 19 measurement 150, 151, 166 seminal vesicle prostaglandin 133, 134 methods, mechanical 151 ATPase and prostaglandin action 6, 7 parity 150, 151 bioregulation, prostaglandin synthesis 3-6 and parturition 146-53 biosynthesis 15-17 pharmacological 152, 153 prostaglandins 44, 49,153-60,414,415 inhibition 18, 19 NSAID modes of action 322, 323 endocervical 158 47, 166 extra-amniotic 156, 157 factors 150 hazards 160 modifications 166, 167 intramuscular 156 blastocyst intravenous 156 oestrogen synthesis 111 oral 156 prostaglandin production 115 systemic 155 vaginal 157, 158 Caesarian section vehicles 155, 156 indications 159, 169, 193 and uterine contractility 155 INDEX 423 cervical score 150, 151 and NSAID 16 factors affecting 150 roles 235 cervical smoth muscle, structure and function 44,45 decidualization 117, 118 cervical stroma 32, 33 DNA synthesis 118 proteoglycan 32, 33 factors affecting 118 cervico-vaginal fistula 189 oil and trauma induced 118 cervix delivery biophysical features 40-4 cessation of bleeding 233 closure mechanism 30, 31,146 events 148 collagen bundles 33 9-deoxo-16, 16-dimethyl-9-methylene PGE2, collagen changes in pregnancy 39, 40 uterine contractility 71, 72 compliance 40, 41 derma tan sulphate 34 and corpus in labour 148 size 39 evaluation methods 45-8 dexamethasone, uterine vasculature 121 extensibility 41, 42 diazoxide features 29 tocolysis 211 fibroblasts 35 uses 211 functions 29, 30 2a, 2b-dihomo-15-methyl PGF2• histology 33-44 abnormal pregnancy 262, 263, 265 hormonal effects 49, 50 intramuscular 266 morphology 30 dilatation and evacuation pregnancy and delivery 30, 35 cervical priming 278 chemical 37 and induced midtrimester abortion 294, 295 prostaglandin effects 51, 52 safety 295 prostaglandin priming 42, 43 16,16-dimethyl PGE 2-p-benzaldehyde semicar• proteoglycan 33 bazone ester ripened, histology 36 abnormal 256, 262, 265 stress-strain curve 41,42 intramuscular 266 uterine control 48, 49 disseminated intravascular coagulation (DIC) 354 chemotaxis, ovum pick-up 84 therapeutic abortion 299, 300 choriocarcinoma 261 dose, addition and multiplication 178 chorion ductus arteriosus, premature closure and arachidonic acid conversion 68 tocolytics 215 renin 342 dysmenorrhoea 11,315-32 CI-628 and implantation 110 causes, primary and secondary 315 ciliary activity, ovum transport role 84, 85 scheme 319, 320 coagulation disorders 254 cervical activity recording 46 prostaglandin abortion 297, 298 definition 315 cod-liver oil 354, 355 dtugs used 322-8 collagen intracervical pressure 44, 45 proteoglycan, prostaglandin effects 39 intrauterine pressure 318 regulation 37 management 328-30 structure, cervical 34, 35 scheme 328 collagenase 37 secondary 330 cervical and delivery method 42 menstrual fluid volume 318 complications, therapeutic abortion 296-300 NSAID effects 65, 66, 316, 370 copper, tubal muscle response 91, 92 oral contraceptives 328, 329 corpus luteum pain, components 319 granulosa cell culture 103 premenstrual tension 371 life-span, factors affecting 102 prostaglandin roles 316, 317, 320, 370 prostaglandin production sites 103, 104 prostaglandin synthesis inhibitors 330, 331, prostaglandin role 102, 103 418 regression 103 uterine activity 318 cyclic endoperoxides 5 uterine contractiliry 62 formation and synthesis 15, 17 cyclo-oxygenase eicosapentaenoic acid (EPA), cyclo-oxygenase inhibitors and implantation 123, 124 pathway 354, 355 424 INDEX

5,8,11,14-eicosatetraenoic acid (EYTA), ovi- prostaglandin synthesis 95 duct contractility 88, 89 inhibitors 88, 89 ejaculate, prostaglandins 138 structure 84 ejaculation, prostaglandin effects 137 fatty acid cyclo-oxygenase, properties 17 elastin 38 fatty acids, prostaglandin precursor 14 endometriosis fertility, male and prostaglandins 134-40 aetiological theories 392-6 fetal death animal models 400 labour induction 189, 190 autoimmunity 394 therapeutic abortion 298 coelomic metaplasia 392, 393 fetal development definition 391 exogenous prostaglandins 122, 123 diagnosis, stages 395, 396 and indomethacin 119 incidence 391 fetal heart rate (FHR), induced labour method induction theory 393 183 infertility 392, 394, 396, 398 fetus, plasma prostanoids 340, 341 inflammation 394 hypertension 345, 346 inheritance 393 flufenamic acid, tocolytic 215 laparoscopy 395 follicular fluid, prostaglandins 100, 101 luteinized unruptured follicle 395, 397, 398 follicular growth 99, 100 peritoneal macrophages 400-2 prostaglandins and hormones, 99, 100 prostaglandin role 397 follicular rupture 413 follicular fluid 399 prostaglandin synthesis inhibitors 101, 102 peritoneal fluid 399, 400 gamete transport 11 secretion 399 gastrointestinal tract prostaglandin synthetase inhibitors 401, 402 disorders and prostaglandins 375, 376 recurrence 396, 397 NSAID effects 375 reproductive functions 394, 395 prostaglandins and premenstrual tension 375 surgery 396 glucocorticoids, prostaglandin synthesis inhi• therapy 396, 397 bition 9-11 types, scanning electron microscopy 401 endometritis, extraovular administration 291 gonadotropin releasing hormone (GnRH) agonists in endometriosis 396 biopsy effects 63, 64 haemostasis in menstruation 65 prostaglandins 59, 114, 115 half-lives, significance 104 formation 63, 64 histamine PGEz binding sites 115 implantation role 120-2 vascular pattern 64 receptors, 120, 121 endoperoxides, uterine contractility 61 hydatiform mole ergometrine clinical management 260, 261 postpartum uterine atony 238, 239, 243 prostaglandin use 260 prophylactic 239 route and dose 263 excretion, prostanoids in hypertensive preg• suction evacuation 255 nancy 345 vaccuum aspiration 261 hydrocephalus 268 Fallopian tube 83-99; see also tubal, hydroperoxy-tetraenoic acids (HPETE) 16 ampullary-isthmic and uterotubal junc• hydroxyproline and collagen content 37 tions hypertension, pregnancy-induced 337-59 ampulla function, prostaglandin effects 91, angiotensin role 350, 351 92 blood pressure changes 347 ciliary activity 84, 85 definition 346 contractility 86-8 and delivery 346 copper ion effects 91-3 objectives of care 337 isthmic function and prostaglandins 91, 92 pathogenesis 346-51 motility control 93, 94 plasma volume 349 layer responses 94 platelet-vascular haemostasis 353, 354 muscle layers, PGEz effects 88 prostaglandin regulation 337, 338 ovum pick-up 83, 84 prostaglandin and thromboxane leveis prostaglandin roles 91, 92 344-6 INDEX 425

fetal tissue 345 tetanic contractions 183 protein urea 352 unripe cervix 148-50 severity scheme 351, 352 infertility spiral artery narrowing 349-51 endometriosis 392, 394, 396, 398 treatment 354-7 seminal fluid prostaglandins 134 inhibition of labour 203-20; see also tocolysis ibuprofen in dysmenorrhoea 324-6, 330, 331 intrauterine contraceptive device (IUD) 66 immunoglobulins in endometriosis 394 copper and prostaglandins 91-3 implantation 414 secondaty dysmenorrhoea 321, 322 AMP, cyclic effects 122 intrauterine fetal death factors affecting 123 clinical management 258 histamine role 120-2 coagulation disorders 254 hormonal control 110, 111 prostaglandin use 259, 260 NSAID effects 111, 119 routes and dose 262 prevention 124, 125 time retained 254 prostaglandin, exogenous effects 122, 123 vaginal delivety, contraindications 260 prostaglandin immunization 120 intrauterine growth retardation (IUGR) 348 stages and prostaglandins 116-20 hypertensive pregnancy 349 study 109 intrauterine pressure registration 183 time after fertilization 109, 110 isoxuprine, tocolytic 213 inactivation sites 8 indomethacin 15-keto-13, 14-dihydro-PGF 2a see dysmenorrhoea 324, 325 PGF2• metabolite excretion 213 9-ketoreductase 153 fetal development 119, 120 kidney function fetal half-life 213 drugs affecting 374 follicular rupture 101, 102 prostaglandin involvement 373-5 implantation effects 111, 112, 119 and prostaglandins 121 labour see also induction, inhibition placenta crossing 213 cervical monitoring 46, 47 protein binding 212 fourth stage 233 thromboxane synthesis 18 induction 72 tocolysis 212-14, 217 initiation 73-5 double blind trial 214, 215 normal 145, 146 uterine vasculature permeability 116, 117, parity and age effects 167 119 premature 52 zona pellucida shedding 116 problems 145 induction of labout 165-93 prostaglandins 75-7 evaluation 167-9 and myometrium 70 fetal death 189 labour, induction method and collagenase 42 fetal maturity 167 laminaria, cervical priming 278, 279, 285, 286 incidence 193 laparoscopy indications 158 dysmenorrhoea 328, 329 methods 169-71 endometriosis 395 morbidity 148-50 leukotrienes neonatal jaundice 191 biosynthesis 16 perinatal mortality 193 structures 15 post-partum bleeding 191, 192 lip oxygenase 4 pre-eclampsia 191 biosynthesis 16 prostaglandin use 170, 171,415 pathways 354 acceptability 178 lung disease and prostaglandins 192 assessment 171, 192-4 luteinized unruptured follicles 395, 397 contraction features 176 endometriosis 397, 398 intravenous 171-9 infertility 398 local 187-91 luteinizing hormone (LH) oral 179-86 prostaglandin involvement 123 oxytocin comparison 172 luteolysis 104 route 176-8, 192 lysosomallabilizers, factors affecting 76, 77 426 INDEX macrophages, peritoneal in endometriosis 400 Nalador, therapeutic abortion 272 magnesium sulphate naproxen sodium myometrial activity 205 dysmenorrhoea 324-6 side effects 206 premenstrual syndrome therapy evaluation tocolysis 205, 206 379-82 short-term 218 tocolytic 215 mastalgia 372 nifedipine mastodynia 372 dysmenorrhoea 327, 328 mefenamic acid 66, tocolysis 206 dysmenorrhoea 324-6 non-steroidal anti-inflammatory drugs (NSAID) premenstrual syndrome evaluation 378 biosynthesis inhibition 18 menorrhagia, mefanamic acid 66 cyclo-oxygenase 212 menstrual cycle, endometrial prostaglandins dysmenorrhoea treatment 65 114,115 66,322-6 Menstrual Log Sheet 379, 380 mechanisms of action 18 menstruation prostaglandin inhibition 9-11, 322 fluid volume 318 sites of action 322, 323 haemostasis 64-6 normal, prostaglandins role 316 obstetric balance 151 pain and prostaglandins 321 assessment 152 PGE2 effects 63 obstetric care, objectives 145 retrograde and endometriosis 392 oestradiol and implantation 110 tissue shedding mechanisms 65 oestrogen uterine activity and stage 316 cervical effects 49 uterine contractility 62 and implantation 110 vascular responses 64 progesterone ratio and labour 74 metabolism 19-21 oral contraceptives in dysmenorrhoea 328, 329 bolus injection 19 ovary 99-105; see also corpus luteum, follicle, pregnant uterus 67-9 luteal systemic administration 63 circulation 100 metabolite monitoring 19 ovarian function and prostaglandins 413 metoprolol in tocolysis 210 ovulation migraine, premenstrual syndrome 373 mechanism 100, 101 p-mimetic agents 219 prostaglandin effects 63 antidiuretic effect 209 ovum pick-up 83, 84 duffuse micronecrosis 209 prostaglandins and role 91, 92 glycogenolysis 209 ovum transport maternal heart rate 208 muscular activity 85 neonatal heart failure 209, 210 prostaglandin role 94, 95 oedema 208, 209 trans-isthmic 90, 91 placental passage 208 oxytocin third stage management 208 cervical effects 50 tocolysis 206-10 contraction features 176 agents 219 labour induction 169 short-term 219 routes 170 use, Europe 208 labour initiation 74, 75 monoamine oxidase, fetal and placental 207 postpartum haemorrhage 239, 240 Montevideo units 147 prostaglandin comparison in induction 172, morning-after pill 124 181 mortality, therapeutic abortion method 299 therapeutic range 176 myometrium toxicity 185 arachidonic acid conversion 68, 69 uterine contractility in pregnancy 72, 73 contractility study 62 uterine receptors 75 pattern and pregnancy 147 postpartum 233 parity and labour duration 167 prostaglandin sensitivity 235 parturition PGI2 production in pregnancy 342 pituitary-adrenal axis 73, 74 prostaglandins and oxytocin in labour 70 sequence of events 75 INDEX 427 perinatal mortality and induction 193 myometrial contractility pattern 147 pessaries, vaginal vehicles 158 prostaglandin changes 338-43 16-phenoxy-PGE2 methyl sulphonylamide prostaglandin production sites 338, 339 cervical priming 284 renin-angiotensin system 343 first trimester abortion 277 pregnancy, abnormal intrauterine 253-698; see mid trimester abortion, routes 293, 294 also individual conditions phenylbutazone, prostaglandin synthesis inhi• clinical management 258-68 bition 10 decision tree 258, 266, 267 phenylephrine, tubal motility response 94 diagnosis 258, 259, 268 phosphodiesterase inhibitors 16,16-dimethyl-PGE2 p-benzaldehyde semi• tocolysis 210, 211 carbazone ester 256 toxicity 211 induction-abortion interval 256, 257 phospholipase 4 prostaglandins and analogues 261-4 phospholipase A2 and implantation 113 intra-amniotic hazard 264 piroxicam in dysmenorrhoea 324 intramuscular 264-6 placenta monitoring 266 arachidonic acid conversion 68 prostaglandin tole 254, 257 171X-hydroxylase 73 sepsis 259 prostaglandin synthesis 74, 338 surgery 268 hypertension 345 termination mechanism 253, 254 retained, therapeutic abortion 297 pregnancy, ectopic, fallopian tube disorders platelets 83 aggregation 235 premenstrual syndrome 367-83 haemostasis in menstruation 65 aetiology 368, 369 prostaglandin effects 236 breast effects 371, 372 -vascular haemostasis 353, 354 in dysmenorrhoea 370, 371 postpartum haemorrhage 233-47, 418 history 367, 368 anti-g suit 243 hormone toles 369 atonic, management 237-47 nutritional counselling 382, 383 blood loss 237 prolactin levels 373 cause 237,238 prostaglandin role 369-76,418 diagnosis 237, 238, 242 symptoms 367, 368 ergometrine and oxytocin 238, 239 evaluation 379-81 fluid replacement 242 global measure 380, 381 hypogastric artery ligation 245 syndrome complex 368, 382 intrauterine lavage 244 synonyms 367, 368 measurement 239, 241 therapy 376-83 prevention 238 flowchart 382, 383 prostaglandin effects 240, 241 NSAID use 378-83 prostaglandin use 245-7 prostaglandin synthesis inhibitors 377 surgery 244, 245 vitamins 377 therapy 241-4 vitamins 369 pharmacological 238-43 progesterone scheme 242 -block theory 74, 211 uterine massage 243 cervical effects 49 uterine tamponade 244, 245 implantation 110, 111 vasopressin infusion 243 premenstrual syndrome therapy 376, 377 postpartum haemostasis 234 prostaglandin synthesis 5 prostaglandin role 234-7 progestins, tocolytic use 211, 212 postpartum uterine atony, ergometrine 238 prostacyclins (PGI 2) post-sterilization syndrome 414 history xiv pre-eclampsia, induction methods 191 metabolism study 21 pregnancy oviduct contractility 87 blood pressure changes 347 plasma levels 21 cervical changes 30, 35 pregnancy-induced hypertension 356 chemical 36, 37 pregnancy levels 237 collagen 39, 40 pregnant uterus production 112 interventions, balance 151 structure 15 428 INDEX prostacyclins (PGIz) - continued assessment, local 190-3 uterine contractility 61 cost 186 vasoactive interrelationships 353, 354 dose and effects 173-5, 180 prostaglandins dosing, oral 184, 185 antihaemorrhagic 236 efficacy, local 188, 189 chemical modification sites 8 efficacy, oral 181, 182 contraindications 260 extra-amniotic 187 double bonds 16 guidelines 185 effects xiv intracervical 187, 188 history xiii, 131 intravaginal 188, 192, 193 hormone interactions 7 local 187-91 inactivation sites 8 oral 179-86 mode of action 3-11 oxytocin 172-86 modulating effects xiv, xv route and dose 177 origin xiii, 131 safety 183, 189, 190, 192 p-oxidation 20 surveillance 184 w-oxidation 8, 9, 20 tablet availability 181 prohaemorrhagic 235 telemetry monitoring 186 receptor inhibitors 124 luteotrophic 102 prostaglandin A (PGA) menstrual cycle endometrium 114, 115 pregnancy-induced hypertension 356 9-methylene, induced abortion 277 structure 14 side-effects 285, 286 prostaglandin B (PGB) structure 14 midtrimester abortion 288, 289 prostaglandin C (PGC) structure 14 ovulation 101 prostaglandin D (PGD) structure 14 ovum transport 90, 91 prostaglandin E (PGE) potency 154 breakdown prevention 132 pregnant uterus contractility 69 breast 371, 372 pregnant uterus production 112, 113 disease associations 376 sperm density 137 ejaculation role 138 uterine activity 43, 44, 61 seminal fluid content 132, 133 uterine synthesis 51 prostaglandin El (PGE 1) uterine vasculature 117 platelet effects 236 vasoactivity 353, 354 structure 14 prostaglandin EJ (PGEJ ) structure 14 prostaglandin Ez (PGEz) prostaglandin F (PGF) , seminal fluid content abnormal pregnancy 262, 263 132,133 analogue structures 22; see also individual prostaglandin F1«, 6-oxo in pregnant uterus analogues 112 uterine activity 23 prostaglandin F2« (PGFz«) breast 371, 372 analogue structures 22; see also individual cervical priming 280 analogues cervical ripening 153 uses 23 effectiveness 159, 160 antigonadotrophic 103 induced labour 157 antifertility effect 122, 123 routes 154-60 cervical priming 280 cervical smooth muscle 44 cervical ripening 153 16,16-dimethyl- induced abortion 277, 284, hazards 160 285 routes 154-60 endometrial binding sites 115 cervical smooth muscle 50 Fallopian tube contractility 86-8 dysmenorrhoea 62 layer. and responses 88 failed abortion 294 first trimester abortion 272, 273 Fallopian contractility 86-8 half-life, plasma 20 first trimester abortion 272-4 hormonal effects 72 follicular rupture 102 induction of labour 172-86 implantation 94 acceptability, oral 186 induction of labour 171 administration, oral 184-6 availability 179 and amniotomy 185 dose and effects 173-5 INDEX 429

intravenous 171-9 collagen stabilization 38, 39 oral 179-86 molecule size 38, 39 and oxytocin 173-9 pseudopregnancy, endometriosis 396 route and dose 177 menstrual cycle endometrium 114, 115 quantification, prostaglandins 132 metabolite measurement 67 15-methyl- (THAM) rabbit, pregnant uterus prostaglandins 113, 114 abnormal pregnancy 262, 263, 265 radioimmunoassays 344 blood loss 282 rat, pregnant uterus prostaglandins 112, 113 cervical priming 281-3 receptors, p-adreno- agonist action 207 midtrimester abortion, dose and route stimulation 206, 207 292,293 relaxin, cervical effects 49, 50 postpartum haemorrhage 246 renal artery stenosis 350 side effects 285, 286 captopril 350 therapeutic abortion 272, 275 pregnancy-induced hypertension 351, 352 mid trimester abortion 288, 289 renal disease, induction methods 191 myometrium in labour 70 renin ovum transport 86, 90, 91 cells, uterus, 342 postpartum haemorrhage 240,241,245 genital tract release 342 postpartum haemostasis 235 reproductive system, prostaglandins 370, 371, pregnant uterus production 112, 113 398 structure and metabolites 14, 15 ritodrine, tocolytic 207 uterine contractility 61 uterine synthesis 51 saline uterine vasculature 117 second trimester abortion 290 prostaglandin F metabolite (PGFM, 13,14- mortality 299 dihydro-15-keto-PGF 2" therapeutic abortion and prostaglandins in endometriosis 400 289,290 prostaglandin G (PGG), features and half-life 5 seminal fluid prostaglandins 131-3, 138,414 prostaglandin H2 (PGH2) and uterine contrac• animal 132 tility 61 human 132, 133 prostaglandin synthesis infertility 134, 135 bioregulation 3-6 measurement 132 calcium 6 sources 133, 134 pathway 4 seminal vesicles, prostaglandin synthesis 133 precursors 5 smooth muscle and prostaglandins 6 prostaglandin synthesis inhibitors see also in- sodium cromoglycate and implantation 120 dividual compounds, tocolysis sperm contraception 124, 125 features and prostaglandin concentration dosage in dysmenorrhoea 323, 324 135-7 dysmenorrhoea 328-30 motility and prostaglandins 135, 136 choice 329 tapered 135, 137 endometriosis 401, 402 transport, passive 137, 138 Fallopian tube effects 88, 89 spinnbarkeit 31, 32 premature labour 52 spiral arteries, narrowing 349-51 premenstrual syndrome therapy 377-82 steroids and prostaglandin synthesis 5 seminal fluid and sperm effects 133, 134 inhibition 10 tocolysis 212-18 structures complications 215 precursors 14 contra indications 218 prostaglandins 13, 14 fetal ductus arteriosus 215, 216 Sulprostone fetal effects 216, 217 abnormal pregnancy 262, 263, 265 maternal tolerance 215 composition 248, 265 neonatal mortality 216 postpartum haemorrhage 240, 248 zona pellucida shedding 116 therapeutic abortion 272, 276 prostatic secretion xiii, xv synthesis inhibition 9-11; see also prostaglan• proteoglycans see also individual proteoglycans din synthesis inhibition cervical 32, 33 syntometrine, postpartum haemorrhage 240 430 INDEX tamoxifen uterine contractility implantation 110 hazard 155 pseudopregnancy 112 modulation 412 testosterone, prostaglandin production 138 non-present, prostaglandin responses 61-6 THAM 272 see also PGF2., 15-methyl-throm- pregnant, prostaglandin responses 66-77 boxanes potency 70, 71 biosynthesis 17 synthesis 66, 67 history xiv prostaglandin potency and routes 62, 63 metabolism 20, 21 PGE2 effects 42-4 structures 13, 14 recording apparatus 46 uterine contractility 62 regulation, non-pregnant 62 thromboxane A2 (TXA2) uterine hypertonia platelet effects 236 clinical significance 176 potency 62 definition 175 pregnancy-induced hypertension 355 fetal risk 183, 184 thromboxane B2 (TXB2) umbilical artery 338, incidence 189, 190 339 induction by prostaglandins 173, 174 tissue binding sites 11 oral 181-3 tissue levels, sampling problem 63 rate 175 tissue specificity 9 local PGE2 189 tocolysis 203; see also prostaglandin synthesis and oxytocin 175 inhibitors uterine rupture, prostaglandin abortion 296 ductus arteriosus patency 215 uterine tamponade 244, 245 indications and agents 219 uterine vasculature permeability 117 long-term 203-18 uteroplacental perfusion, p-mimetic effects 209 drugs 204-12 uterotubal junction (UT J) 83,413 short-term, indications 218, 219 la yers 59, 60 agents 219 structure 84 tocolytic drugs 203 uterus 59-77; see also endometrium, myome- uterorelaxant 218 trium total daily production rates 20 corpus, architecture 59, 60 tranylcypromine and decidualization 119 dye site reaction 117 tricuspid insufficiency 215, 216 homogenates, prostaglandin production 112, tropocollagen 36 113 tubal lock irritability test 185 copper and prostaglandin role 91-3 layers, prostanoid responses 59 oestrogen-induced 95 oxytocin sensitivity 165 tubal motility 399 pregnant, prostaglandin production 112-15 tylose, vehicle 156 rabbit 113, 114 rat 112, 113 UK-37, 248; thromboxane synthetase inhibi• prostaglandin synthesis 67-9 tion 355, 356 sites 51 ulcerative colitis 376 sensitivity in pregnancy 165, 166 umbilical blood vessels, prostaglandins in hypertension 344 vasoactivity, prostaglandins in pregnancy 341, umbilical muscle, prostaglandin synthesis 338 342 urinary excretion and kinetics 20 vasopressin, labour initiation 74 urine vegetable oil and decidual cell reaction 119 electrolytes and prostaglandins 374 verapamil in tocolysis 206 maternal prostanoids 340, 341 vitamins in premenstrual syndrome 377, 383 hypertension 346 uterine blood flow WHO Prostaglandin Task Force 293 controlling factors 350 and prostaglandins 341 zona pellucida shedding 116