The induction of abortion and the priming of the cervix with prostaglandin F2 alpha and prostaglandin E2 by intra-amniotic, extra-amniotic and intra-cervical application (author's transl)

Abstract

More than 130 terminations of pregnancy in the 2nd and 3rd trimesters are reported. In 100 cases, the results of priming prior to therapeutic abortion in the 1st trimester of pregnancy are available. Compared are application for induction of abortion by the extraamniotic, the intraamniotic, and the intracervical route. The results with PGF2alpha and PGE2 gel intracervically are reported. The shortest interval between induction of abortion and abortion was 15 hours with regular application of PGE2 gel into the cervical canal. The failure rate was reduced to 5% with regular applications. The failure rate with irregular application was 22%. With the intraamniotic administration of PGF2alpha, the most severe side effects such as shock symptoms or bronchospasm were noticed. Gastrointestinal side effects such as diarrhea were only noticed with the administration of PGF2alpha. Following a single intracervical application, the so-called priming dose, 67-69% of the cases reached a sufficient dilatation of the cervix up to Hagar number 8. In 16-19% of the cases with the application of PGE2, a spontaneous abortion was achieved with a single dose. Side effects such as marked uterine cramps, nausea, and vomiting were noticed in less than 30% of the cases receiving a priming dose. Our results suggest that a regular and short term application of PG is necessary for the induction of abortion. Relatively short intervals between induction of abortion and abortion and a low failure rate of induction of abortion can thus be achieved. The intracervical application of PGE2 gel or PGF2alpha gel results in sufficient and gentle dilatation of the cervix for a suction curettage in the 1st trimester of pregnancy in about 70% of the cases. The priming dose is recommended for primigravidas or cases with rigid cervix. (author's)