Prostaglandins

Physiological effect of prostaglandins:

1. The central nervous system is oppression, stupor, catatonia, tremor, irritation and oppression of neurons, contracture of the musculature of the extremities.
2. Heart and blood circulation - increased heart rate and stroke volume, decreased arteriolar tone, increased venous tone, lower blood pressure, increased calcium in the heart muscle (cygitalis-like effect).
3. Lungs - decrease arteriovenous oxygen difference, decrease and increase in bronchial resistance (bronchodilation and bronchoconstriction).
4. Gastrointestinal tract - lowering of gastric secretion, stimulation of motor function of stomach and intestines.
5. Urogenital system - sodium naresis, potassium urine, increased diuresis, increased urea clearance, stimulation of renin secretion, increase and strengthening of motor function of the uterus.
6. Endocrine organs are an antagonistic effect on the action of insulin, glucagon, corticosteroids and catecholamines.
7. Metabolism - increased synthesis of glycogen, an increase or decrease in the content of free fatty acids.
8. Blood - the effect on the aggregation of erythrocytes and platelets, on the coagulation of blood.

Clinical manifestations of the action of prostaglandins:

Effects of PGE ₂ :

• reduces systemic arterial pressure;
• directly dilates small arteries in various organs;
• inhibits the action of pressor hormones;
• improves blood supply to the brain, kidneys, liver, limbs;
• increases glomerular filtration, creatinine clearance;
• reduces the reabsorption of sodium and water in the renal tubules and increases their excretion;
• reduces the initially increased ability of platelets to aggregate;
• improves microcirculation;
• increases blood oxygenation;
• leads to resorption of fresh ischemic foci in the fundus and reduces the number of fresh hemorrhages in the retina of the eye.

Effects of PGF2:

• increases systemic arterial pressure, increases arterial pressure in the pulmonary artery;
• reduces the saturation of blood with oxygen;
• reduces blood flow in the organs;
• directly increases the tone of the vessels of the brain, kidneys, heart, intestines;
• potenziruet vasoconstrictor action of pressor hormones;
• increases sodium naresis and diuresis.

Since 1970, natural prostaglandins have been used as therapeutic agents in obstetric and gynecological practice for the maturation of the cervix and premature termination of pregnancy, with the aim of induction and rhodostimulation.

Various ways of administering prostaglandins have been suggested, however, it has been found that parenteral and oral administration requires relatively large doses of prostaglandins, as they are mainly inactivated in the mother's lungs, and also cause a number of side effects, in particular, nausea, vomiting, diarrhea, tachycardia, cover, muscle tremor, allergic reactions, etc.

In recent years, prostaglandins have become increasingly common in obstetric practice for topical use, since they have the property of "local" hormones.

We recommend the introduction of prostaglandin gel intravaginally together with carboxymethylcellulose according to the following indications:

• in pregnant women of high risk (symptoms of impairment of the fetus, placental insufficiency, etc.) a method has been developed for the joint use of beta-adrenomimetics (partus, alupent, bricanil, ginipral) together with prostaglandins to avoid cases of hyperstimulation of the uterus or deterioration of the fetus;
• introduction of gel with prostaglandin in case of untimely passage of amniotic fluid and immature neck of uterus;
• with the purpose of treating the weakness of labor activity against insufficient availability of the organism for childbirth (maturing or immature cervix of the uterus).

Contraindications for the use of prostaglandins in obstetric practice:

• organic heart disease;
• arterial hypertension (over 140/90 mm Hg);
• diseases of the respiratory system (bronchial asthma, allergic bronchitis, emphysema, bronchiectatic disease), active tuberculosis;
• peptic ulcer, ulcerative colitis, severe disorders of kidney and liver function, epilepsy, glaucoma;
• blood diseases (sickle cell anemia, clotting disorder);
• collagenosis, a burdened allergic anamnesis (anaphylaxis in the past);
• postoperative surgical interventions on the uterus (caesarean section, conservative myomectomy), uterine fibroids, malformations of the uterus.

[1], [2], [3], [4], [5], [6]