Tse On Ki. / Thesis submitted in: June, 1997. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1998. / Includes bibliographical references (leaves 97-113). / Abstract also in Chinese. / List of Tables --- p.xiii / List of Figures --- p.xiv / List of Abbreviations --- p.xv / Chapter Chapter 1. --- Introduction to thesis --- p.2 / Chapter 1.1 --- Misoprostol --- p.2 / Chapter 1.1.1 --- Description and History of Drug --- p.2 / Chapter 1.1.2 --- Current Use in Obstetrics and Gynaecology --- p.3 / Chapter 1.1.2.1 --- Termination of Pregnancy (TOP) --- p.3 / Chapter 1.1.2.2 --- Cervix Priming prior to Surgical Treatment of Pregnancy Failure --- p.4 / Chapter 1.1.2.3 --- Medical management of spontaneous abortion --- p.4 / Chapter 1.2 --- Gemeprost --- p.4 / Chapter 1.3 --- Doppler Sonography and Assessment of Blood Velocity --- p.5 / Chapter 1.4 --- Overview of Thesis --- p.5 / Chapter 1.5 --- Aim of this Study --- p.8 / Chapter Chapter 2. --- Physiological and Anatomical Features of Pregnancy --- p.10 / Chapter 2.1 --- Cardiovascular System Changes in Pregnancy --- p.10 / Chapter 2.1.1 --- Changes in the Blood --- p.10 / Chapter 2.1.2 --- Changes in Circulation --- p.11 / Chapter 2.1.3 --- The Distribution of Blood Flow in Uterus --- p.12 / Chapter 2.2 --- Blood Supply to Uterus --- p.13 / Chapter 2.3 --- Pelvic Anatomy in Early Pregnancy via Transvaginal Sonography --- p.15 / Chapter 2.3.1 --- Uterus --- p.15 / Chapter 2.3.2 --- The Adnexa --- p.17 / Chapter 2.3.3 --- Other Pelvic Structures --- p.17 / Chapter Chapter 3. --- Prostaglandins and Analogues --- p.19 / Chapter 3.1 --- Natural Prostaglandins --- p.19 / Chapter 3.2 --- The Source of PGs in Reproductive Organs of Women --- p.19 / Chapter 3.3 --- PGs Synthesis and Metabolism --- p.20 / Chapter 3.4 --- PGE1 Analogue: Misoprostol --- p.21 / Chapter 3.4.1 --- Misoprostol --- p.22 / Chapter 3.4.1.1 --- Pharmacology --- p.22 / Chapter 3.4.1.2 --- Adverse Side Effects --- p.23 / Chapter 3.4.1.3 --- Toxicology --- p.23 / Chapter 3.4.1.4 --- Misoprostol in Obstetrics & Gynaecology --- p.24 / Chapter 3.4.1.4.1 --- To Induce Abortion in First and Second Trimesters --- p.24 / Chapter 3.4.1.4.2 --- Cervix Priming prior to Surgical Evacuation of Uterus --- p.27 / Chapter 3.4.1.4.3 --- Medical Management of Miscarriage --- p.28 / Chapter 3.4.1.4.4 --- Induction of Labour with Dead Fetus --- p.29 / Chapter 3.4.1.4.5 --- Induction of labour --- p.29 / Chapter 3.4.2 --- The Potential Dangers of PGE1 analogues --- p.30 / Chapter Chapter 4. --- Doppler Sonography and Parameter Measurements --- p.34 / Chapter 4.1 --- The Principles of Ultrasound and Doppler Sonography --- p.34 / Chapter 4.1.1 --- The Basic Principles of Ultrasound --- p.34 / Chapter 4.1.2 --- Principles of Doppler Sonography --- p.36 / Chapter 4.2 --- Doppler Mode --- p.39 / Chapter 4.2.1 --- Continuous Wave Doppler Imaging --- p.39 / Chapter 4.2.2 --- Pulsed Wave Doppler Systems --- p.39 / Chapter 4.2.3 --- Colour Doppler Sonography (CDS) --- p.40 / Chapter 4.3 --- The Instrument of Doppler Sonography --- p.40 / Chapter 4.4 --- "Resistance Indices - S/D, PI and RI" --- p.42 / Chapter 4.5 --- Flow Measurement of Uterine artery --- p.44 / Chapter 4.5.1 --- Sampling Sites and Waveforms --- p.44 / Chapter 4.5.2 --- Waveform Components --- p.45 / Chapter 4.5.3 --- Identification of the Main Uterine Arteries --- p.45 / Chapter 4.5.4 --- UA Waveform Changes in Normal Pregnancy --- p.46 / Chapter 4.5.5 --- Factors Affecting the UA Waveforms --- p.48 / Chapter 4.5.6 --- Uterine Artery Resistance in Normal Pregnancy and Labour --- p.49 / Chapter 4.5.6.1 --- Uterine Artery Resistance in Normal Pregnancy --- p.49 / Chapter 4.5.6.2 --- Uterine Artery Resistance during normal labour --- p.51 / Chapter 4.5.7 --- Doppler Measure of Fetal Heart Rate --- p.52 / Chapter 4.6 --- Sonography in Estimation of Gestational Age --- p.53 / Chapter Chapter 5. --- Research Protocol --- p.56 / Chapter 5.1 --- The Ethics --- p.56 / Chapter 5.2 --- Apparatus --- p.58 / Chapter 5.3 --- Drug and Dosage --- p.59 / Chapter 5.4 --- Research Protocol --- p.59 / Chapter 5.4.1 --- Subjects --- p.59 / Chapter 5.4.2 --- Transvaginal Scan --- p.60 / Chapter 5.4.3 --- Parameters Measured --- p.61 / Chapter 5.4.4 --- Misoprostol --- p.65 / Chapter 5.5 --- Data analysis --- p.66 / Chapter Chapter 6. --- Results --- p.68 / Chapter 6.1 --- The Patients' Characteristics --- p.68 / Chapter 6.2 --- The Intra-observer Error --- p.70 / Chapter 6.3 --- Results of Study --- p.70 / Chapter 6.3.1 --- Effect of Misoprostol on the S/D ratio of Both Uterine Arteries --- p.70 / Chapter 6.3.2 --- Effect of Misoprostol on the PI of Both Uterine Arteries --- p.73 / Chapter 6.3.3 --- Effect of Misoprostol on Fetal Heart Rate (FHR) --- p.76 / Chapter 6.3.4 --- Left and Right UA-S/D --- p.78 / Chapter 6.3.5 --- Left and Right UA-PI --- p.81 / Chapter 6.3.6 --- The relationship Between Subgroups --- p.84 / Chapter 6.3.7 --- Side Effects of Misoprostol --- p.85 / Chapter 6.3.8 --- The Changes of UA-S/D and UA-PI According to Gestation --- p.86 / Chapter Chapter 7. --- Discussions and Conclusions --- p.89 / Chapter 7.1 --- Difficulties Encountered during Study --- p.89 / Chapter 7.2 --- Results of Study --- p.90 / Chapter 7.3 --- Implications --- p.94 / Chapter 7.4 --- Summary of Thesis --- p.95 / Chapter 7.5 --- Conclusions --- p.96 / Chapter 8. --- References and Appendix --- p.97