Abortion induction in the 2d pregnancy trimester. Endocervical PGE2 gel administration, intramuscular sulprostone administration and combined (endocervical PGE2 gel/intramuscular sulprostone) treatment

Abstract

In 74 patients with normal pregnancy, termination of pregnancy was induced during 1980-1983 for medical reasons (12%) or for eugenic reasons (88%) in the second trimenon of pregnancy. We compared endocervical PG-E2 gel application (if necessary, several doses of 0.5 mg PG-E2 gel every 4-6 hours in 25 cases) with intramuscular application of sulproston (500 micrograms sulproston IM every 4-6 hours in 26 cases) and the combined endocervical application of PG-E2 gel (single administration of 0.5 mg PG-E2 gel endocervically) plus systemic application of sulproston (500 micrograms sulproston IM every 4-6 hours) in 23 cases. The average gestational age in the groups under comparison was 21 to 22 weeks of pregnancy. In the group with combined application, in endocervical PG-E2 gel application and systemic sulproston application IM, complete or incomplete abortion was seen after regular application within 20 hours in 100% of the cases. With regular PG-E2 gel application endocervically we found complete or incomplete abortion in only 79% of the cases within 36 hours, and with the IM application of sulproston in 94% of the cases under observation within 36 hours. Combined application of PG-E2 endocervically and systemic application of sulproston led to a statistically significant saving of sulproston (average total dose = 0.9 mg) together with significant reduction of the abortion induction interval to 8 hours after the first IM sulproston dose. (For comparison: Abortion induction interval after endocervical PG-E2 gel application = average 24.6 hours, and after IM sulproston application = average 15.9 hours).(ABSTRACT TRUNCATED AT 250 WORDS)