Experience with PGF2 alpha in mid-trimester pregnancy termination in Ibadan

Area of Science:

• Obstetrics and Gynecology
• Reproductive Medicine
• Pharmacology

Background:

• Mid-trimester pregnancy termination presents unique clinical challenges.
• Surgical methods for second-trimester abortion carry inherent risks.
• Alternative methods are sought to improve safety and efficacy.

Purpose of the Study:

• To evaluate the efficacy and safety of intra-amniotic prostaglandin F2 alpha (PGF2 alpha) for mid-trimester pregnancy termination.
• To assess the complication rate and required interventions associated with this method.

Main Methods:

• A retrospective review of 25 cases of mid-trimester pregnancy termination using intra-amniotic PGF2 alpha.
• Doses of PGF2 alpha ranged from 40 to 80 mg, with 88% receiving 66 mg or less.
• Data collected on abortion success, time to abortion, need for surgical intervention, and side effects.

Main Results:

• Complete abortion without surgical intervention occurred in 52% of patients.
• The mean interval from instillation to abortion was 22 hours.
• Surgical intervention was required in 12 patients (48%).
• Gastrointestinal symptoms were the most common side effects, reported in 72% of patients.
• No cases of epileptic seizure or cervical laceration were reported.

Conclusions:

• Intra-amniotic PGF2 alpha can be an effective method for mid-trimester pregnancy termination.
• The procedure is associated with a significant rate of gastrointestinal side effects and a notable need for surgical intervention.
• Use of PGF2 alpha for pregnancy termination should be limited to centers with comprehensive medical facilities to manage potential complications.