10 Prostaglandin analogues and their uses

Abstract

Health practitioners can administer prostaglandin analogues through noninvasive routes; this expands their clinical use for pregnancy termination. They can be used to terminate early and second trimester pregnancy as well as to dilate the cervix preoperatively for pregnancy termination after the 7th week of gestation, e.g., vacuum aspiration. Failure to dilate the cervix can result in cervical laceration, uterine perforation, hemorrhage, or incomplete evacuation of the conceptus. Preoperative treatment with prostaglandin analogues facilitates vacuum aspiration and decreases the likelihood of operative and postoperative complications. Gemeprost is administered vaginally in a pessary form. Sulprostone and carboprost are delivered intramuscularly. These 2 prostaglandin analogues are very effective in inducing mid and late second trimester abortions. Intrauterine administration of abortifacient drugs increases the risk of inadvertent intravenous injection of the drugs. Prostaglandin analogues increase the efficacy of RU-486's (an antiprogestin) ability to induce medical termination of early pregnancy to almost 100%. Further, addition of a prostaglandin analogue to RU-486 administration decreases the duration of labor and the frequency of side effects during early pregnancy termination.