A comparison of termination of pregnancies in the 2nd trimester induced by intraamniotic injection of hypertonic saline, prostaglandin F2alpha or both drugs.

Abstract

In recent years prostaglandins have been used to induce abortion. The effect is due to the ability of the prostaglandins to cause uterine contractions. Intraamniotic hypertonic saline interrupts pregnancy by terminating the foetus and destroying the placenta. For many years we have had satifactory results with the latter method. However, it was considered that results might be improved by combining prostaglandin and hypertonic saline in a single therapeutic regime. In order to investigate the problem, 75 pregnant women of 13-19 weeks gestation were divided into 3 groups. In group I abortion was induced by 20% saline given intra-amniotically (max. 200 ml), in group II by 25 mg prostaglandin F2alpha and in group III by injecting both drugs simultaneously. The injection was never repeated. If abortion had not occurred within a time limit of 48 hours an oxytocin drip (120 MU/min) was given. If abortion had still not taken place within 24 hours after setting up the oxytocin drip the case was classified as unsuccessful. In the saline group 52% had an abortion within 48 hours and 72% within 72 hours after the intraamniotic injection, the average being 45,6 hours. In the prostaglandin group the corresponding figures were 68% and 92% and the average time from injection to abortion being 37,2 hours. In the combination treatment group the figures were 96% and 100% with the average time of 20,3 hours. The frequency of side effects and complications were low and equal in the three groups. Only the frequency of vomiting was different. In group I: nil, in group II: one case, and in group III: three cases. No episodes of diarrhoea was observed.