Comparison of prostaglandin F2α and hypertonic saline for induction of midtrimester abortion

Abstract

Midtrimester abortions were induced in two compatible groups of patients in the second trimester by intra-amniotic instillation of either prostaglandin F2α or a 20 per cent sodium chloride solution. Nine of the 10 patients in the prostaglandin group aborted completely, with a mean abortion time of 15.16 hours. All of the 10 patients in the saline group aborted completely, and the mean abortion time was 20.34 hours. One patient in the prostaglandin group failed to abort during the prostaglandin instillation, and abortion finally had to be completed surgically. The 2 groups were compared with regard to uterine activity and plasma levels of progesterone, human prolactin, human placental lactogen, and cortisol, as well as urinary excretion of estrone, estradiol, estriol, and pregnanediol. The endocrine changes were rather similar in the 2 groups. The side effects in the 2 groups were carefully studied and found to be fairly similar although gastrointestinal symptoms were more frequent in the prostaglandin group. Lactation in the postabortion period was more frequent in the prostaglandin group. The similarities suggest that the mechanism of abortion may not be much different with the 2 methods. To decide which one of the methods is safest requires the study of much larger groups of patients for comparison.