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WORLD HEALTH ORGANIZATION STUDIES OF PROSTAGLANDINS VERSUS SALINE AS ABORTIFACIENTS

A Reappraisal

From the U.S. Department of Health. Education, and Welfare, Center for Disease Control, Family Planning Evaluation Division, Atlanta, Georgia

The World Health Organization (WHO) Task Force on the Use of Prostaglandins for the Regulation of Fertility has sponsored a series of randomized clinical trials and case-series investigations to assess the effectiveness and safety of prostaglandins as abortifacients. Our reanalysis of the WHO studies found the prostaglandins to be faster and more hazardous than hypertonic saline as intraamniotic abortifacients. Moreover, studies by the Center for Disease Control imply that dilatation and evacuation (D&E) may be more effective, safe, convenient, and inexpensive than prostaglandins for abortions after 12 weeks' gestation, especially in the 13- to 16-week interval. For gestations of < 17 weeks, the occurrence of live births in prostaglandin-induced abortions has produced serious legal and ethical problems in the United States. Until the effectiveness and safety of other prostaglandins regimens approach that of D&E, we feel that D&E should be the index of comparison against which newer methods of inducing abortion are tested.