2308 second trimester terminations using extra-amniotic or intra-amniotic prostaglandin E2: an analysis of efficacy and complications.

A total of 2308 mid-trimester terminations using PGE2 extra-amniotically (1608) or intra-amniotically (700) has been analysed for efficacy and immediate and early morbidity. The mean induction-to-abortion intervals were similar for the two routes. Overall, 67% of the patients were in hospital for 1 night. Morbidity rates were similar for the two administration routes and were no higher than those reported for second trimester terminations using dilatation and evacuation. Minor side-effects of vomiting occurred in 1006 (44%) and diarrhoea in 320 (14%). Forty (1.7%) lost more than 500 ml of blood during termination and 13 (0.6%) were transfused. Major complications were extremely rare and genital tract trauma only occurred in 4 (0.17%) and proven pelvic infection in 2 (0.08%) patients. Thirty-three (1.4%) were readmitted and required a surgical evacuation of the uterus. Since long-term complications have been assessed for this method of termination and found to be infrequent, we see no reason to consider a change in methods for second trimester terminations.