[Indications of choice for extra-amniotic perfusion of physiologic serum]

After a preliminary report on 20 cases, we have used extra-amniotic perfusion of isotonic saline, in association or not with syntocinon, for performing:--56 2nd trimester therapeutic abortions,--16 labor inductions in interrupted 2nd and 3rd trimester pregnancies, with macerated fetus (missed abortion and missed labor). This method, relatively simple, permits the discharge of the conceptus within a reasonable time. Our experience allowed us to draw the indications of choice in the use of this method, which are the following: 1. When the amniotic puncture may be difficult (at the beginning of the 4th month or if the age of pregnancy is uncertain). 2. When there is an increased risk of hemorrhage with coagulation disorder macerated fetus or some systemic diseases). 3. When there are counter-indications for the use of hypertonic saline solution or prostaglandins (some renal, cardiac or respiratory diseases). 4. When one needs a fetus in a relatively good state for embryologic, histologic or genetic studies, which are important in case of abortion for rubella or chromosomic anomaly. In view of the innocuousness of this method, its use for labor induction in evolutive pregnancies is suggested.