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At least 19 recordsLinked to original sources

Extraovular prostaglandin F2alpha for early midtrimester abortion.

Twenty patients who were 13 to 15 weeks pregnant received extraovular prostaglandin F2-alpha (PGF2a) in dosages of 3 mg. every 1 to 3 hours. Ninety-five per cent of the patients successfully aborted and 30 per cent of the patients had retained placental tissue. The mean abortion time was 17 3/4 hours and the average total dose used was 29.2 mg. The abortion time appeared to decrease with parity and had no relationship to weeks of gestation. Only one patient failed to abort after 31 hours of therapy. She required a curettage and was the only patient to develop a postabortion infection. The technique appears to compare favorably with the results of intra-amniotic PGF2a. Extraovular prostaglandin may therefore be of particular value in inducing abortion in patients who are in the early midtrimester of pregnancy, i.e., when intra-amniotic instillation is technically infeasible.

Abortion, Induced↗

Intra-amniotic urea and prostaglandin F2alpha for midtrimester abortion: clinical and laboratory evaluation.

The clinical management of the elective midtrimester abortion continues to be unsatisfactory as judged by either national mortality or morbidity rates. This report documents the results of a randomized series of 19 midtrimester abortions induced by either intra-amniotic hyperosmolar urea and 5 mg. of prostaglandin F2alpha (PGF2alpha) or intra-amniotic hyperosmolar urea alone. Pertinent clinical characteristics and biochemical determinations were compared between these two groups. A series of 150 patients were then treated with urea and 5 mg. of PGF2alpha. The clinical results of this series of patients are presented and compared with a previous group who had urea and 10 mg. of PGF2alpha. These studies demonstrate that 5 mg. of PGF2alpha with 80 Gm. of urea achieves injection-abortion intervals that are less than 24 hours.

Abortion, Induced↗

Dilation and evacuation: a preferred method of midtrimester abortion.

A comparison between two methods of therapeutic termination of midtrimester pregnancies was performed. Twenty-nine patients at 13 to 16 weeks' gestation underwent dilation and evacuation (D and E). A second group, of 29 patients at 16 to 19 weeks' gestation underwent therapeutic abortion by prostaglandin F2 alpha instillation. There was a significantly lower complication rate (6.9% versus 55%) and a shorter hospital stay of 1 full day in the D and E group. Also, the blood loss was not significantly greater in the D and E group.

Abortion, Therapeutic↗

Factors influencing morbidity in termination of pregnancy.

This study analyzes the morbidity of therapeutic abortion and identifies predisposing factors. A retrospective case evaluation of 2,105 pregnancy terminations was performed. Major complications occurred in 5% of those undergoing curettage procedures, 41% of women undergoing prostaglandin amnioinfusion, and 17% of those who had hysterotomy as a method of abortion. Age, parity, and history of previous pregnancy termination, had little effect on morbidity. Surgical/technical factors and reliance on amnioinfusion and hysterotomy as procedures of choice for pregnancy termination contributed significantly to the high morbidity rates. This contribution, however, was overshadowed by the influence of patient delay, physician delay, and limited abortion facilities, resulting in 35.4% of pregnancy terminations being performed in the midtrimester. Improvements in abortion technique may lower the incidence of complications, but the need for more appropriate facilities is emphasized.

Abortion, Induced↗

Urea-prostaglandin versus hypertonic saline for instillation abortion.

Authorities have suggested use of a combination of hyperosmolar urea and low-dose prostaglandin F2 alpha as a second-trimester intra-amniotic abortifacient to avoid the disadvantages of hypertonic saline solution. To examine the safety and efficacy of urea-prostaglandin compared with the instillation of saline solution, we analyzed data from a prospective multicenter study conducted in the United States between 1975 and 1978. Both agents were highly effective in producing an abortion. However, urea-prostaglandin had a significantly lower rate of serious complications when compared with saline solution (1.03 versus 2.18 per 100 abortions; p less than 0.001). Urea-prostaglandin also had a significantly shorter induction-to-abortion time (14.2 versus 25.6 hours; p less than 0.001). Urea-prostaglandin, therefore, appears to be superior to hypertonic saline solution as an abortifacient.

Abortifacient Agents↗

Midtrimester pregnancy termination by intravaginal administration of prostaglandin E2.

The intravaginal administration of prostaglandin E2 (PGE2) in repeated doses of 20 mg was evaluated for efficacy and safety in 400 midtrimester pregnancy terminations. Patients were assigned to three treatment groups. Group A (232 patients) received PGE2 alone, Group B (106 patients) had prior intracervical laminaria insertion, Group C (62 patients) received both laminaria and continuous intravenous oxytocin infusion. Complete abortion was achieved in 328 cases (82 per cent) and there were 13 failures (3.3 per cent). Mean instillation treatment groups were not statistically significant but outcome was more favorable in pregnancies of 16 to 19 weeks' gestation as compared with those between 13 and 15 weeks. Gastrointestinal symptoms and temperature elevation constituted the most frequent side effects. Excessive blood loss occurred in 11 cases (2.8 per cent) and live births were encountered in 12 cases (3.0 per cent). Vaginal PGE2 is felt to be particularly acceptable for the termination of pregnancies of 16 to 19 weeks' gestation.

Abortion, Induced↗

Uterine rupture: a complication of midtrimester abortion.

The intraamniotic injection of prostaglandin F2alpha and/or hypertonic saline may be associated with serious uterine and cervical trauma. Multiparity and superimposed uterotonic stimulation by oxytocin are generally thought to be contributory. A patient is described who failed to abort vaginally after an uneventful intraamniotic infusion of prostaglandin F2 alpha in combination with hypertonic saline; 48 hours later she evacuated the uterine contents into the peritoneal cavity through a rent in the uterine fundus. The uterine rupture occurred even though there had been no uterotonic stimulation by oxytocin.

Abortion, Induced↗