Prostaglandin induction of 424 midtrimester abortions.

Abstract

424 pregnant women seeking termination of 2nd trimester pregnancy had either PGF2alpha (290 women) or PGE2 (134 women) administration. Oxytocin was concomitantly administered as an intravenous infusion to 185 women. The patients were divided into 11 groups based on PG (prostaglandin) type and dose, route of PG administration, and oxytocin infusion (Table 1). Vital signs were monitored hourly and blood samples collected from most patients for analysis of erythrocyte sedimentation rate, hemoglobin, blood leukocytes, and glutamic oxaloacetic transaminase before induction, at or immediately after abortion, and 24-48 hours after abortion. Side effects reported included diarrhea, vomiting, headache, and vasovagal symptoms. Complications included bleeding of 500 ml or more; pelvic infection and cervical rupture. Intraamniotic administration of 50 mg PGF2a either alone or with supplemental intravenous oxytocin, and intraamniotic use of 10 mg of PGE2 supplemented with oxytocin provided the best results in terms of success rate (100%) and shortest induction-abortion interval (14.1 to 16.2 hours). Extraamniotic administration had success rates ranging from 83% to 90%, depending on frequency of PG application. Intravenous PG administration was associated with low efficacy and high frequency of side effects.