Vaginal prostaglandin E2 for missed abortion and intrauterine fetal death

Vaginal suppositories containing 20 mg. of prostaglandin E2 (PGE2) were given to 50 patients with a diagnosis of either missed abortion or fetal death. A total of 94 percent of the patients (47/50) expelled products of conception, and 84 percent of these expulsions (42/50) were complete. The mean time to expulsion of the fetus was 11.3 hours with a mean dose of 3.6 suppositiries. A total 60 per cent of the patients experienced vomiting, diarrhea, and pyrexia. Four patients had a blood loss in excess of 500 ml., and two of these patients required blood transfusion. Vaginal administration of PGE2 suppositories appeared to be a rapid, safe, and reliable means of managing missed abortion and intrauterine fetal death.