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Coagulation changes during second-trimester abortion induced by intra-amniotic prostaglandin E2 and hypertonic
Lancet (London, England)
|November 29, 1975
Summary
Intra-amniotic prostaglandin E2 combined with hypertonic urea during abortion can cause disseminated intravascular coagulation. This risk is less pronounced with hypertonic glucose, and absent with prostaglandin E2 alone.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Pharmacology
Background:
- Second-trimester abortion induction commonly uses pharmacologic agents.
- Prostaglandin E2 (PGE2) is used alone or with adjunctive agents.
- The risk of coagulation abnormalities with these methods requires investigation.
Purpose of the Study:
- To investigate the effects of intra-amniotic prostaglandin E2 (PGE2) combined with hypertonic urea or glucose on the coagulation system.
- To determine if these induction methods are associated with intravascular coagulation.
Main Methods:
- Studied 27 patients undergoing second-trimester abortion.
- Administered intra-amniotic PGE2 alone, PGE2 with hypertonic urea, or PGE2 with hypertonic glucose.
- Monitored coagulation parameters including fibrin degradation products, plasma fibrinogen, and platelet count.
Main Results:
- Patients receiving PGE2 with hypertonic urea showed increased fibrin degradation products and decreased plasma fibrinogen and platelets.
- Similar, but less severe, coagulation changes were observed with PGE2 and hypertonic glucose.
- No significant coagulation changes were detected in patients receiving PGE2 alone.
Conclusions:
- Intra-amniotic PGE2 combined with hypertonic urea poses a risk of disseminated intravascular coagulation during induced abortion.
- Hypertonic glucose presents a lesser risk of coagulation abnormalities compared to urea.
- The hypertonic agent, particularly urea, appears to be the primary driver of these coagulation changes.