Intraamniotic prostaglandin F2 alpha for pregnancy termination in the second and early third trimesters of pregnancy.

OBJECTIVE

To examine the effectiveness and safety of intraamniotic prostaglandin F2 alpha (PGF2 alpha) instillation during second- and early third-trimester termination of pregnancy.

STUDY

DESIGN

The study group consisted of 173 women between 18 and 32 weeks of gestation admitted for termination of pregnancy with a live, singleton fetus. The procedure included intraamniotic instillation of 40 mg PGF2 alpha. In cases of failed induction; after 24 hours an additional procedure (repeated PGF2 alpha injection, oxytocin augmentation or extraovular balloon installation) was performed.

RESULTS

The mean induction-to-abortion interval was 27 +/- 17 hours, 26 minutes. The induction-to-abortion interval was not significantly influenced by parity, maternal age, indication for pregnancy termination or gestational age at the time of the procedure. Complications were related to a longer induction-to-abortion interval (35 hours, 41 minutes +/- 26 hours, 15 minutes in complicated cases as compared to 25 hours, 43 minutes +/- 15 hours, 28 minutes, P = .012). However, complications were uncommon.

CONCLUSION

Intraamniotic PGF2 alpha instillation was safely used for termination of pregnancy, even at advanced gestational ages. The induction-to-abortion interval is the main factor influencing complications and is important as a catalyst for cases that fail to abort within 24 hours.