Midtrimester abortion utilizing intraamniotic prostaglandin F2alpha, laminaria and oxytocin

The combined use of 40 mg of intraamniotic prostaglandin F2alpha, followed immediately by the insertion of one or more laminaria tents, and of a high-dose oxytocin infusion of 166 milliiunits per minute is a safe, effective, and efficient regime for midtrimester abortion. In 100 consecutive patients between 16 and 20 weeks of gestation, no failures occurred. The mean injection-abortion time was 15.7 hours. Six patients required the reinjection of 20 mg of prostaglandin F2alpha at 24 hours. The placenta was removed with instruments after four hours in 19 patients and done electively in seven patients in less than four hours. Physician-patient contacts were minimized, for all the abortion-initiating techniques were accomplished concomitantly, as opposed to regimes with laminaria pretreatment, or deliberately staggered prostaglandin injections were used. Most of the patients were able to be discharged after one day in the hospital. Thus, the patients' inconvenience and expense were minimized, with no sacrifice in safety.