Induction Of Midtrimester Abortion Research Articles

Effect of vaginal pH on the efficacy of vaginal misoprostol for induction of mid trimester abortion

Effect of vaginal pH on the efficacy of vaginal misoprostol for induction of mid trimester abortion

Fetal fibronectin as predictor of successful induction of mid-trimester abortion

Fetal fibronectin as predictor of successful induction of mid-trimester abortion

The use of vaginal prostaglandins for the induction of mid trimester abortion

(1988). The use of vaginal prostaglandins for the induction of mid trimester abortion. Journal of Obstetrics and Gynaecology: Vol. 8, No. sup1, pp. S28-S32.

Arachidonic acid in amniotic fluid after extra-amniotic instillation of rivanol for midtrimester abortion

Free arachidonic acid was measured by gas liquid chromatography in amniotic fluid in 13 women during induction of midtrimester abortion. The abortions were induced by extraamniotic instillation of 0.1% Rivanol. Serial sampling of amniotic fluid were performed through a trans-abdominal catheter up to 22 hrs. Free, total arachidonic acid showed a significant increase from 26±8 ng/ml to 293±102 ng/ml at 22 hrs. The percentage of free arachidonic acid in total free fatty acids increased significantly from 2.2±0.5 to 6.1±1.6% during the same time. The C results suggest a selective release of arachidonic acid during Rivanol-induced abortion.

Limitations of a single extra-amniotic injection of prostaglandins in viscous gel to induce midtrimester abortion.

A dose-response study using PGE2 in a viscous gel has been undertaken for induction of midtrimester abortion. A direct relationship was found between the time to abortion and the dose administered. However, even using PGE2 3.5 mg induced uterine activity was noticed to subside in a significant number of women after approximately 6 h. For routine management it is suggested that PGE2 3.5 mg be injected and followed by repeat doses 6 h later with removal of the injecting catheter on each occasion.

Coagulopathy with midtrimester induced abortion: Association with hyperosmolar urea administration

Coagulation changes, usually subclinical, have been reported in association with the induction of midtrimester abortion by the administration of intra-amniotic hypertonic sodium chloride, hyperosmolar urea, hyperosmolar urea plus prostaglandin F2α, and hyperosmolar ura or hypertonic glucose plus prostaglandin E2. In addition, clinically significant coagulopathy has been described in association with the administration of hypertonic sodium chloride. This study details a three-year experience involving 3,034 cases of midtrimester elective abortion and describes six cases of coagulopathy in association with the administration of hypertonic sodium chloride and two cases in association with the administration of hyperosmolar urea. The significance of these findings and etiologic considerations are discussed.

Induction of midtrimester abortion with intra-amniotic urea and intravenous oxytocin

Midtrimester abortions were induced in 295 patients with a combination of intraamniotic urea and intravenous oxytocin. The mean injection-abortion interval was 26.4 hours. Abortion occurred spontaneously within 50 hours of amnioinfusion in 257 patients. The macerating effects of the hypertonic urea on fetal tissues allowed easy termination of the remaining 38 pregnancies by suction curettage at 50 hours after injection. Decreased urinary output occurred during the oxytocin infusions, but water intoxication was prevented by close monitoring of urinary output and serum electrolytes, and by the use of a concentrated solution of oxytocin in normal saline, allowing the administration of small volumes.

Induction of Midtrimester Abortion by the Combined Method of Continuous Extra Vovular Infusion of Prostaglandin F2α and Intracervical Laminaria Tents

Midtrimester abortion was successfully induced in 55 of 60 patients with continuous extraovular infusion of prostaglandin F2alpha (PGF2alpha) following the insertion of intracervical laminaria tents. Intravenous oxytocin was also used in 38 (63%) of the 60 patients. The mean induction-abortion time (IAT) was 11.72 hours +/- 1.06 SD). Abortion was completed in 40% within 8 hours, 80% within 16 hours, and 93% within 24 hours. The mean total dose of PGF2alpha was 41.9 mg. There was no significant difference in IAT between the parous patients (13.40 hours +/- 1.90 SD) and the nulliparous patients (10.41 hours +/- 1.13 SD). There was no apparent correlation between IAT and the stages of gestation (12 to 22 weeks). The five patients who failed to abort within 24 to 36 hours underwent uterine evacuation, which was easily accomplished because there was a marked degree of cervical dilatation. Side effects and complications of the technique were few. Endometritis occurred in three patients, two of whom had had intrauterine devices in situ until just prior to the procedure. It appears that this method has a high success rate, an acceptable safety factor, good patient tolerance, and relatively few side effects.

Experience with 276 intra-amniotic prostaglandin F 2α induced midtrimester abortions

Induction of midtrimester abortion using 40 mg intra-amniotic prostaglandin F 2α was performed on 276 patients. Gestational age and fetal status had no effect on injection-to-abortion time while multiparity and the concomitant use of laminaria appeared to decrease the abortion time. The side effect and complication rates were acceptable and the results compare favorably with those of other midtrimester abortion techniques.

Effect of prostaglandin F2α and hypertonic saline on the placental function during midtrimester abortion

Changes in placental function during the induction of midtrimester abortion by prostaglandin F2α and hypertonic saline were investigated. Serial estimations of human placental lactogen (HPL) and cystine aminopeptidase (CAP) were carried out in 17 subjects. There was a significant (P < 0.01) reduction in the plasma CAP and HPL levels 4 hours after PGF2α administration. In the case of hypertonic saline abortions only HPL levels showed a reduction at 8 and 12 hours after induction.

Induction of midtrimester abortion by serial intravaginal administration of 15(S)-15-methyl-prostaglandin F 2α (THAM) suppositories

Midtrimester abortion was successfully induced in 13 of 22 patients by serial intravaginal administration of 15(S)-15-methyl-prostaglandin F 2α (THAM) suppositories. Nine patients, 4 nulliparas and 5 multiparas, failed to abort after 24 hours of prostaglandin administration and a concomitant infusion of oxytocin was initiated. Seven of the nine patients aborted within 7 hours of the combined therapy and one patient on methadone maintainence aborted after 17.5 hours of combined therapy, 41.5 hours after the first dose of prostaglandin. A single patient failed to abort, despite the concomitant prostaglandin-oxytocin administration and underwent surgical evacuation. The mean abortion time for the 21 successful abortions was 22.56 hours. Nulliparous patients aborted somewhat faster, mean 21.79 hours, than multiparous patients, mean 23.80 hours, but this difference was not statistically significant. In this study, one patient aborted in less than 12 hours, and 62% of the successful cases aborted within 24 hours. The plasma levels of 15-ME-PGF 2α were analyzed by radioimmunoassay in 10 patients. Plasma prostaglandin levels rose significantly 30 minutes after the insertion of the first suppository, but there was a wide variation in levels from patient to patient. It was observed that the 2 patients with the highest levels had the fastest abortion times and episodes of gastro-intestinal side effects appeared related to a rise in prostaglandin levels. Sixty-four percent of the patients in this study had no gastro-intestinal side effect related to prostaglandin administration.

Induction of mid-trimester abortion by means of extra-amniotic infusion of an isotonic saline solution combined with intravenous oxytocin drip infusion

Abortion was successfully induced in twenty cases of mid-trimester pregnancies using extra-amniotic infusion of an isotonic saline solution followed by intravenous drip infusion of 10 to 30 units of oxytocin. the abortions were completed within 9–72 hours after the beginning of the procedure. there was no failure and no complications.

The Use of Prostaglandin F2αfor the Induction of Mid-Trimester Abortion

Summary: Ninety-eight patients were given prostaglandin F2α for the induction of mid-trimester abortion. In 42 the PGF2α was administered by the extra-amniotic route and 37 aborted. A further 56 received the PGF2α intra-amniotically and 55 aborted. Dose regimens are compared.

Coagulation changes during termination of pregnancy by prostaglandins and by vacuum aspiration.

Serial studies on coagulation factors were performed on 12 patients having termination of mid-trimester pregnancy by extra-amniotic prostaglandin F(2)alpha and 11 patients terminated by vacuum aspiration during the first trimester. A significant change in the activity of factors V, VII and X, VIII, and X, and a decrease of the prothrombin time and platelet count were found with prostaglandin termination but no such changes occurred during vacuum aspiration. These findings suggest that the coagulation system is activated during induction of mid-trimester abortion with extra-amniotic prostaglandin F(2)alpha. This is probably related to the physiological changes in the coagulation mechanism which occur by the second trimester of pregnancy. Termination of pregnancy in the mid-trimester may, however, be expected to give rise to defective blood coagulation and thromboembolic complications.

Rivanol-induced mid-trimester abortion (report on 200 cases).

Extra-amniotic instillation of 0.1 per cent rivanol was used for induction of mid-trimester abortion in 200 cases. No serious complications were observed in connection with the instillations. Both the success rate and the incidence of salpingitis were higher when a balloon-catheter was retained during the whole induction period than when a Nelathon catheter was withdrawn after each instillation. The results may indicate that rivanol should be substituted for hypertonic saline in the induction of mid-trimester abortions.

Induction of midtrimester abortion by increasing intra-uterine volume.

Abstract. The intra‐uterine volume of 10 obstetrically normal nulliparous midtrimester patients was increased by the intra‐amniotic instillation of 350 ml Macrodex. There were 2 treatment failures due to the rupturing of the fetal membranes within 2 hours of the instillation. In all the remaining 8 patients the intra‐uterine pressure increased gradually, following volume increase. However, it only reached the magnitude demanded for clinical abortion in 4.

Hormonal changes during induction of midtrimester abortion by prostaglandin F2α

Prostaglandin F2α was infused over 12 hours in 10 patients between 12 and 16 weeks' gestation. There were 4 complete and 5 incomplete abortions. All patients developed significant side effects. Plasma levels of human chorionic gonadotropin, follicle-stimulating hormone, progesterone, free estrogens, and renin were determined serially. Results indicate functional damage of the placenta and fetus prior to clinical evidence of abortion.

Induction of midtrimester abortion by intra-amniotic administration of prostaglandin F 2 . A preliminary report.

Induction of midtrimester abortion by intra-amniotic administration of prostaglandin F 2 . A preliminary report.