Termination of 128 Pregnancies in the 2nd Trimesterof Pregnancy by Administration of prostaglandin15 Methyl F2alpha

Overview

Objective:
The critical analysis of the authors’ standard protocol of termination of pregnancyduring the second trimester.Design: The prospective nonrandomised study.Setting: Department of Gynecology and Obstetrics, 1 th Faculty of Medicine, Prague.Methods: We used a synthetic prostaglandin analog carboprost, 15-methyl-prostaglandin F2alphafor induction of abortion during second trimester. It was administered in a single dose 500 mikro-grams. It was given into the amniotic cavity through the transabdominal puncture. At the sametime dinoprostonum gel (0.5 mg) was given into vagine. Peridural analgesia has used since begin-ning of contractions. We investigated indication, mean period of induction, correlation betweenthe period and indication and week of pregnancy so as a type and number of complication.Results: From October 1998 till January 2000 128 pregnancy were terminated by intraamnioticprostaglandins administration. After a single administration 67.2% of women aborted within 24hours. In 32.8% the intraamniotic administration was repeated twice. The mean induction period,i.e. the interval between the administration and abortion of the foetus was 28 hours. We didn’tdetect a correlation between the period of induction and the week of gestation or indication.Complications: A major blood loss replaced by transfusion of erythrocyte mass at 4 cases, a restin uterus at 3 cases, once perforation of uterus during revision ot the uterine cavity, once sectiominor for bleeding, once major bleeding conjoined with septic shock, once phlebotrombosis andat three headache (in connection with peridural analgesia).Conclusion: The therapeutic effect was achieved in all instances. One case of sectio minor wasconnected with strong vaginal bleeding. The method fulfils condition for second-trimester termi-nation of pregnancy - must be safe, rapid, psychologically feasible and associated with a minimalrisk of long-term consequences. The disadvantage of the method is the price of prostaglandinsand necessity to repeat administration in 32.8% of patients.

Key words:
termination of pregnancy, prostaglandins, second trimester