Vaginally administered prostaglandin E2 as a first and second trimester abortifacient

Area of Science:

• Obstetrics and Gynecology
• Reproductive Medicine
• Pharmacology

Background:

• Second-trimester pregnancy termination is a critical aspect of reproductive healthcare.
• Various pharmacological agents are employed for medical abortion, each with distinct efficacy and safety profiles.
• Prostaglandins have emerged as key agents in medical induction of labor and abortion.

Purpose of the Study:

• To evaluate the efficacy and safety of prostaglandin E2 (PGE2) vaginal suppositories for second-trimester pregnancy interruption.
• To determine the abortion interval and completion rates using PGE2 suppositories.
• To compare the outcomes with existing prostaglandin and hypertonic saline regimens.

Main Methods:

• A prospective study involving 100 women seeking pregnancy interruption between 7-20 weeks of gestation.
• Administration of prostaglandin E2 (20 mg) as a vaginal suppository every four hours.
• Monitoring for abortion achievement within a 36-hour time limit and assessing completeness of abortion.
• Use of adjunctive intravenous oxytocin for placental expulsion as needed.

Main Results:

• Abortion was achieved in 97% (97 out of 100) of patients within the 36-hour limit.
• Complete abortion occurred in 76% of patients.
• Mean abortion intervals varied from 7.67 to 14.93 hours based on gestational length and parity.
• Common side effects included vomiting, diarrhea, and drug fever; however, no sepsis or transfusions were required.

Conclusions:

• Prostaglandin E2 vaginal suppositories are an effective method for second-trimester pregnancy interruption.
• The regimen demonstrates a high success rate and a generally favorable safety profile, with manageable side effects.
• Further comparison with other prostaglandin and hypertonic saline regimens is warranted to establish optimal therapeutic strategies.