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Comparison of Extra- and Intra-amniotic Prostaglandins for Therapeutic Abortion

From the Department of Obstetrics and Gynecology, University of Edinburgh, Simpson Memorial Maternity Pavilion and Royal Infirmary. Edinburgh

Abstract

Intra-uterine administration of prostaglandins E₂ and F₂₀ has been used for the termination of 148 second trimester pregnancies as part of the general service commitment of a busy gynecologic unit. Prostaglandin E₂ was used almost exclusively for the extra.amniotic route, with a mean induction-abortion interval of 18 hours, 35 minutes in 103 patients (mean dosage 2.96 mg); 10 of these required supplemental oxytocin when abortion was delayed. Intra-amniotic PGF₂ (10 mg) gave a mean induction-abortion interval of 1-1 hours, 10 minutes (16 cases) with supplemental oxytocin in 1 case. Intra-amniotic PGF₂₀ (25 cases) was less effective, even when given in an initial dose of 50 mg, the mean induction-abortion interval at this dosage being 20 hours, 47 minutes. Additional oxytocin was required in 20% of PGF₂₀ cases. Minor side effects were frequent with all methods. Three cases (1 severe) of bronchospasm occurring with PGE ₂ have been described.