Intraamniotic urea for induction of midtrimester pregnancy termination: a further evaluation

Forty percent hyperosmolar urea solution was used intraamniotically to induce midtrimester pregnancy termination in 508 patients. The mean injection-abortion interval was 43.4 hours in those patients aborting within 7 days (85.8% of the total group); 76% of the group aborted within 72 hours. Complications from the procedure included endometritis, hemorrhage, and nausea and vomiting; 29.3% of the patients required operative completion of the abortion (placental removal 12 hours after passage of the fetus). There were no cases of hypernatremia, cardiac arrest or collapse, clinically evident coagulopathies, nor cervical lacerations. This study supports the conclusion that urea is a safer intraamniotic solution than hypertonic saline for midtrimester pregnancy termination.