Abortion in early pregnancy by vaginal administration of 16,16-dimethyl-PGE 2 in comparison with vacuum aspiration

Abstract

16,16-dimethyl -PGE 2 is a prostaglandin analogue which has been shown to be effective in termination of second trimester pregnancy following vaginal administration. It is associated with a lower frequency of gastrointestinal side effects than any other analogues so far tested. The efficacy of vaginal suppositories containing 16, 16-dimethyl-PGE 2 for termination of early pregnancy (5 to 8 weeks of gestation) was evaluated in 88 women. Two different dose schedules were used: either a 0.8 mg suppository every third hour four times or a 0.8 mg suppository at 0 and 3 hours followed by a 1.0 mg suppository at 6 and 9 hours. The latter dose resulted in complete abortion in 94 per cent of the patients. Bleeding generally started two to eight hours after start of treatment and lasted for 10 to 14 days. Gastrointestinal side effects were limited to 0.4 to 0.5 episodes per patient. Vaginal administration of 16,16-dimethyl-PGE 2 was also randomly compared with the operative procedure, vacuum aspiration, in 77 patients. It could be concluded that the two methods were equally effective but that vacuum aspiration was superior with regard to time, duration of bleeding and frequency of gastrointestinal side effects. The advantages of the vaginal treatment was the simplicity of the administration and its possibility for self-administration which for some patients may outweigh the disadvantage of the method in comparison with the operative procedure.