Interruption of First Trimester Pregnancy by Prostaglandins

Abstract

ABSTRACTVacuum aspiration is today's most used method for pregnancy termination before 13 weeks of gestation. Under certain circumstances, the administration of prostaglandins may offer clinically important advantages. Intrauterine administration of primary prostaglandins (PGE2 or PGF2α) or their analogues, or vaginal administration of 15‐(S)‐15 methyl PGF2α methyl ester or of 16,16 dimethyl PGE2 are effective for terminating early first trimester pregnancy (up to 3 weeks following the first missed menstrual period). Compared to the vacuum aspiration procedure, the frequency of complete abortion is the same for prostaglandins administration, but the time to complete the procedure, duration of bleeding and frequency of gastrointestinal side effects are superior for vacuum aspiration. Since intrauterine administration technically resembles vacuum aspiration, it appears that it offers no major clinical advantages over vacuum aspiration. If the vaginal route is used, the simplicity of the method, which allows for self‐administration on an outpatient basis, is for some patients more important than the advantages of the surgical prcedure. In addition, administration of prostaglandins to reduce or eliminate the need for mechanical dilatation is a clinically valuable method, especially in primigravid patients.