Late second trimester abortion with 16,16-dimethyl-trans-delta 2-PGE1 methyl ester (gemeprost)

Area of Science:

• Obstetrics and Gynecology
• Reproductive Medicine
• Pharmacology

Background:

• Second-trimester pregnancy termination often involves surgical evacuation.
• Alternative medical methods are sought for improved patient outcomes and safety.
• Gemeprost, a prostaglandin E1 analog, has been explored for labor induction and pregnancy termination.

Purpose of the Study:

• To investigate the efficacy and safety of gemeprost vaginal pessaries for terminating late second-trimester pregnancies.
• To determine the abortion rate and induction-abortion interval using gemeprost.
• To evaluate gemeprost as a non-surgical alternative to dilatation and evacuation.

Main Methods:

• An open, single-center study involving 56 nulliparous women.
• Administration of 1 mg gemeprost vaginal pessaries.
• Dosage adjusted based on patient response, with up to 5 doses.
• Monitoring for abortion success, time to abortion, and complications.

Main Results:

• An overall abortion rate of 58.9% (33 out of 56 women) was achieved.
• The mean induction-abortion interval was 15.2 hours.
• No serious complications were reported during the study.
• Abortion success did not show a statistical correlation with gestational age.

Conclusions:

• Vaginal gemeprost pessaries are a safe and effective option for inducing therapeutic abortion in the late second trimester.
• Gemeprost offers an acceptable alternative to surgical evacuation for selected patients.
• The procedure should be initiated with the capacity for immediate surgical intervention (dilatation and evacuation) if necessary.