Prostaglandin Induction of Midtrimester Abortions: Three Years' Experience of 626 Cases

In the first part of the survey 424 midtrimester abortion inductions with 11 different regimes of treatment were analyzed according to PG dose, PG type (PGF 2α or PGE 2 ), the route of administration (intravenous, extra‐amniotic, and intra‐amniotic), and the dose of concomitant intravenous oxytocin. Intraamniotic PG was given as a single injection, and the dose was repeated after 24 hours, if the abortion was not imminent. The highest efficacy, a 90% success rate within 24 hours and a 100% rate in 48 hours, as well as the shortest induction‐abortion interval were achieved with the intra‐amniotic administration of 50 mg of PGF 2α either alone or with supplementary oxytocin, or with the intra‐amniotic 10 mg PGE 2 plus oxytocin. In the latter part of the survey 202 prostaglandin inductions were carried out as a clinical routine. Forty or 50 mg of PGF 2α was given intra‐amniotically, and supplementary oxytocin infusion was commenced on the basis of individual judgment. The success rates were somewhat lower and the abortion times longer than in the inductions which were carried out by the research team. Side efects were usually slight and well tolerated. Cervival ruptures (nine cases) and profuse bleeding requiring blood transfusion (19 cases) were the most serious complications. All patients with a cervical rupture were primigravidas induced with intraamniotic PGF 2α ; a supplementary oxytocin infusion was given to eight of them.