Mid-trimester therapeutic abortion by intra-amniotic prostaglandin F2 alpha and concomitant oxytocin

The routine use of intra-amniotic PGF2 alpha and concomitant intravenous oxytocin for second trimester induced abortion is evaluated in 274 consecutive cases. Eighty-five per cent of the nullipara and 90 per cent of the parous women aborted within 24 hours and all but one within 48 hours following a single intra-amniotic dose. Doses were 40 or 50 mg PGF2 alpha and the mean induction-abortion interval was not shortened by the higher dose. Neither did gestational age have any effect on abortion time. Postabortum haemorrhage occurred in 22 cases in spite of routine curettage. Parametritis was reported in eight cases. In two nullipara, cervical tears were observed, in one case forming a persisting fistula to the uterine cavity. There were no significant toxic side effects to the administration of PGF2 alpha or oxytocin. It is concluded that the method has not been superseded with regard to efficacy of abortion induction and that the rate of more serious complications is not above what can be expected from any other available method of second trimester pregnancy termination.