The Induction of Second Trimester Abortions Using an Intra‐amniotic Injection of Urea and Prostaglandin E₂

Induction of 2nd-trimester abortion in 31 patients in England is described. An intraamniotic injection of 80g urea was administered after ensuring a free flow of amniotic fluid. The injection was followed by 5mg PGE2 (prostaglandin E2) injected into the amniotic cavity. The procedure was successful in 30 of the 31 patients, requiring a mean injection-to-abortion time of 10 hours and 30 minutes (ranging from 4 hours 10 minutes to 26 hours). 6 of the successful cases required general anesthesia for subsequent evacuation of retained conception products. Neither gestational age nor parity was associated with the injection-to-abortion interval. The described procedure is judged to be safe, rapid, and relatively inexpensive. It reduces the risk of maternal mortality connected with saline injection. It reduces the time required for urea injection alone. It reduces the cost of intraamniotic PG alone.