Postconceptional induction of menses with double prostaglandin F2α impact

Abstract

To evaluate whether a double prostaglandin impact enhances the effectiveness of the 15S-15-methyl prostaglandin (PG) F2 alpha methyl ester analogue in 1st and 2nd trimester abortion, 2 vaginal suppositories spaced 3 hours apart were administered to 10 patients. The patients' ranged from 19-39 years; length of gestation ranged from 44-56 weeks. Uterine contraceptions began from 40-190 minutes after suppository insertion, and bleeding was seen within 120-610 minutes. 3 of the 10 subjects expelled products of conception during the 10-hour observation period. All subjects reported persistent vaginal bleeding after the procedure, and in 8 subjects the bleeding continued for 14 or more days. 6 subjects reported repeated nausea and vomiting, and 7 experienced diarrhea. Both plasma progesterone values and human chorionic gonadotropin (hCG) beta-subunit levels declined during the 10-hour observation period. The significant drop in beta-subunit hCG levels noted at the follow-up visit indicated 8 of the pregnancies had been successfully interruped showed a drop in plasma progesterone levels, showing that this measure does not predict outcome. Overall, the results in this small series do not suggest any improvement in efficacy over that reported with a single vaginal suppository. The frequency and severity of gastrointestinal side effects appeared to be greater and vaginal bleeding was more porlonged. In addition, uterine contractions began earlier and were more intense, requiring greater use of analgesic medication. It is possible, however, that more applications of smaller dosages given at shorter intervals could improve efficacy and reduce the frequency and severity of side effects.