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[Anti-prostaglandin agents in obstetrics]
P Gaucherand1, I Rigot-Mignon, R C Rudigoz
1Service de Gynécologie-Obstétrique, Hôpital de la Croix-Rousse, Lyon.
Abstract:
First the authors recall the synthesis cycles of prostaglandins and the main physiological effects of the latter. Taking into account these effects, antiprostaglandins can be used in two obstetrical pathologies: the threat of premature labour, the delayed intra-uterine development with or without toxaemia. In the particular case of the threat of premature labour, the authors report a certain number of clinical observations concerning non-steroidal anti-inflammatory drugs and namely indometacin, showing the efficacy of the treatment. They also evoke the complications of this therapy where the stenosis of the arterial canal and its repercussion on the renal function predominate. They conclude with some practical advice. In the particular case of delayed intra-uterine development with or without toxaemia, the authors put forward some physiopathological arguments leading to the use of the combination Aspirin/Dipyridamole. They report the results of their personal experience. Out of 52 cases taking platelet aggregation inhibitors, 43 are linked with an obstetrical pathology and amongst them, 86 p. cent have a pathological past record (severe toxaemia, isolated DIUD, DIUD + toxaemia, IUFD). In the great majority of cases, treatment was administered before 20 WA. The pregnancy progressed normally in 76 p. cent of the cases and all the pathologies observed were minor. No serious complications have been reported. The average term of pregnancy is of 38 WA with an average growth weight of 2,920 g. The efficacy seems better if the past record is a DIUD rather than a toxaemia. The authors then compare their results with the literature data.(ABSTRACT TRUNCATED AT 250 WORDS)