Early complications and sequence of pregnancy interruption with hypertonic saline

Midtrimester abortions and a number of cases with missed labor were induced by intrauterine instillation of 30% saline solution in 103 women. The instillation-abortion time was relatively short (mean 25.4 h) while oxytocin was not needed for the augmentation of contractions either in elective abortions or missed labor. Eighty-seven women had a curettage after the abortion; this was directly related to fetal weight. The first puncture was unsuccessful in 11 women (10.7%) and a second puncture was made a week later. Ten women had early complications, mainly fever for a few days; there were no instances of uterine perforations or disseminated intravascular coagulopathy (DIC). Postabortal curettage decreased the incidence of early complications. All study patients had a follow-up examination after 2 to 22 yr from the abortion. In 10 women some sequelae were found, but only in three women was the problem possibly related to the saline abortion (hydrosalpinx, incompetent cervix, and intrauterine adhesions). Of 71 women who subsequently wished to become pregnant, 69 succeeded: seven had more than one pregnancy, in three there were recurrent abortions. In 94 patients menstruation was normal, in eight bleeding became heavier, and there was one case of oligomenorrhea. In the authors' experience and contrary to other publications, midtrimester abortion with concentrated saline has been safe and rapid, and late sequelae have been rare and less important than after early induced abortions.