Efficacy of amikacin in septic abortion: serum and urine antibiotic concentrations.

Septic abortion is a frequent cause of maternal death in our patient population. The great majority of bacteria isolated were enterobacteria. Since antibiotics capable of destroying the cell wall release endotoxins (reducing vasoconstriction and tissue hypoxia) antibiotics which do not destroy bacteria like amikacin are preferred. Amikacin, 500 mg intramuscularly every twelve hours, was used concomitantly with uterine curettage and fluid and electrolyte restoration in thirty septic abortion patients. All the patients responded, obviating the need for more heroic surgical treatment such as hysterectomy. Previously used antibiotics have not been as effective in our patient population.

[Effect of prostaglandin F2a on the contractility of the pregnant human uterus]. / Efecto de la prostaglandina F2a sobre la contractilidad del útero humano grávido

PIP: (PGF2alpha) Prostaglandin F2alpha was administered intraamniotically to 16 patients in 3 groups: molar pregnancy (8 cases), fetal death (6 cases), and anencephalic fetus (2 cases). These particular types of situations were selected because the effects of PGs upon the product were unknown. PG was administered in dosages between 3 and 200 mcg after being prepared in an ethanol solution. It appeared to have no effect on uterine contractility. It is best to start contractility stimulation with low doses which should be increased progressively according to uterine response. Tone, intensity, frequency, and uterine activity increased when PG dose was increased. Uterine labor as to maturity and cervical dilatation, was studied in the 3 groups. Blood pressure was registered in 2 patients with molar pregnancy; there were no changes during the 1st hours of the study. However, during the last part, differential pressure increased by systolic increase. In 4 patients with fetal death, cervical dilatation register was taken. Average dilatation time (going from 2-10 cm) was 9.50 hours. There were such side effects as slight nausea, vomiting, and chills. 1 of the patients presented with hypotension upon administration of PGF2alpha 200 mcg. 4 patients suffered complications; 1 with molar pregnancy had a possible pulmonary embolism by trophoblast, another had hemorrhage and hypotension, 1 patient with fetal death had immediate hypotension after administration of 200 mcg, and the other had deciduo-myometritis which cleared with antibiotics and curettage. No other subjects experienced complications. Intraamniotic PG administration produced few side effects. (author's modified)^ieng