Midtrimester abortion produced by intra-amniotic prostaglandin F2α augmented with intravenous oxytoxin

Saline-instillation abortion with laminaria and megadose oxytocin

This study examines the effect of laminaria and oxytocin in 638 saline instillation abortions. Laminaria were inserted into the cervical canal in the physician's office 2 to 3 hours before admission to hospital for instillation. Pitocin was given intravenously at a rate of 417 to 555 mu/min starting 2 hours after instillation. Pitocin was given intravenously at a rate of 417 to 555 mu/min starting 2 hours after instillation. Center for Disease Control (CDC) criteria were used to define complications in the present series. Complication rates compared favorably to those in a national CDC study of traditional saline procedures. Instillation-abortion times averaged 12.5 hours in the present series, about half the time previously reported for saline abortion. If confirmed by other studies, laminaria and oxytocin will be beneficial adjuncts for managing patients aborted by saline instillation.

The current status of prostaglandins as abortifacients

The present use and potential uses of prostaglandins as abortifacients are summarized. Pertinent history, chemistry, prostaglandins' possible role in physiologic and pathologic processes and pharmacologic actions are discussed. The results of natural prostaglandins and their analogues by systemic and intrauterine administration for the purposes of postcoital contraception, menstrual regulation, first- and second-trimester abortion, preoperative dilation of the cervix, and delivery of patients with death in utero are presented. The only approved method of induction of abortion with prostaglandins, prostaglandin F2alpha by the intra-amniotic route for the induction of midtrimester abortion, is evaluated and compared to other methods of midtrimester abortion. It was concluded that: (1) the present use of prostaglandins is an important addition to the obstetrician's armamentarium, (2) more effective and/or convenient methods that are useful in patients over a wider gestational age appear to have been defined, and (3) the routine use of prostaglandins for postcoital contraception, menstrual regulation, and first-trimester abortion will require the development of analogues that are more specific as to their abortifacient actions than the natural prostaglandins and/or the development of improved delivery systems.

Preliminary experience with 15 (S) 15-methyl prostaglandin F2 alpha for midtrimester abortion

Twenty-six women received intramuscular or intra-amniotic 15 (S) 15-methyl prostaglandin F2 alpha to induce midtrimester abortion. The median initial injection-abortion interval was 10 hours and 25 minutes. The advantages of intramuscular analogue are somnolence and reduced discomfort during labor. Disadvantages include severe gastrointestinal toxicity in the majority of patients and symptoms of acute respiratory distress in two patients.