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Midtrimester abortion with prostaglandin and hypertonic saline--a comparative study.

R V Bhatt, S Pachauri, E Koshy

    International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics
    |January 1, 1978
    PubMed
    Summary

    Comparing intraamniotic prostaglandin F2alpha (PGF2alpha) and 20% saline for pregnancy termination, 20% saline showed higher effectiveness and fewer side effects. Saline resulted in significantly lower rates of incomplete abortion and faster procedures.

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    Area of Science:

    • Obstetrics and Gynecology
    • Reproductive Medicine
    • Pharmacology

    Background:

    • Second-trimester pregnancy termination is a critical aspect of reproductive healthcare.
    • Evaluating different intraamniotic agents for efficacy and safety is essential for optimizing clinical practice.

    Purpose of the Study:

    • To compare the safety and effectiveness of intraamniotic prostaglandin F2alpha (PGF2alpha) versus 20% saline, both augmented with oxytocin, for second-trimester pregnancy termination.
    • To assess method failure rates, incomplete abortion rates, procedural time, and incidence of side effects.

    Main Methods:

    • A comparative study involving 200 pregnancies between 14 and 20 weeks' gestation.
    • Intraamniotic administration of either PGF2alpha or 20% saline, with intravenous oxytocin augmentation.

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  • Evaluation of outcomes including method success, abortion completeness, and adverse events.
  • Main Results:

    • 20% saline demonstrated no method failures, while PGF2alpha had ten failures.
    • Incomplete abortion rates were significantly lower with saline (19.4%) compared to PGF2alpha (33.7%).
    • Saline resulted in a significantly shorter mean instillation-to-abortion time and lower incidence of gastrointestinal side effects and bleeding.

    Conclusions:

    • Intraamniotic 20% saline augmented with oxytocin is a safer and more effective method for second-trimester pregnancy termination than PGF2alpha.
    • 20% saline offers advantages in terms of efficacy, reduced complications, and procedural efficiency.