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

The use of gemeprost (16,16-dimethyl-trans-delta 2-PGE1 methyl ester) vaginal pessaries for the termination of pregnancy in the late second trimester has been investigated in an open single-center study. Of 56 nulliparous women between 18 and 22 weeks amenorrhoea, 33 (58.9%) aborted after the administration of 1 mg gemeprost pessaries; 5 women did abort after 3 doses, 10 after 4 doses and 18 after 5 doses. There was no statistical correlation between gestational age and abortion. The mean induction-abortion interval was 15.2 hrs (range 8.5-20.3 hrs). There were no serious complications. The safe induction of therapeutic abortion in 58.9% of women using vaginal gemeprost pessaries alone offers an acceptable alternative to surgical evacuation in the late second trimester but should not be started without the possibility to terminate the procedure by dilatation and evacuation (D + E).