Comparison of intra-amniotic prostaglandin F2 alpha and hypertonic saline for induction of second-trimester abortion.
The efficacy and safety of intra-amniotic prostaglandin (PG) F2 alpha (25 mg repeated in six hours) and hypertonic saline (200 ml 20% NaC1) were compared in an international multicentre randomised study organised by the World Health Organisation's prostaglandin task force. Both hypertonic saline and PGF2alpha were found to be effective in terminating second-trimester pregnancy. The main advantage of PGF2alpha however, was its greater efficacy, with significantly higher success rates in the first 48 hours. Out of 717 women given PGF2alpha 614 (85-6%) aborted within 48 hours; by 24 hours 439 (61-2%) had aborted, and by 36 hours 574 (80-1%) had aborted. Out of 796 women given hypertonic saline 641 (80-5%) aborted within 48 hours; however, by 24 and 36 hours, respectively, only 161 (20-2%) and 462 (58%) had aborted. Although PGF2alpha was associated with a somewhat higher frequency of minor side effects than hypertonic saline, notably vomiting and diarrhoea, these were within acceptable limits. Only 59 women (8-2%) in the prostaglandin group had more than four episodes of vomiting and 11 (1-5%) more than four episodes of diarrhoea. Ohter side effects occurred only occasionally. No difference was found between the two groups in the frequency of incomplete abortion or excessive bleeding.
D000028:Abortion, Induced / Q000379:methods*; D000650:Amnion; D003967:Diarrhea / Q000139:chemically induced; D005260:Female; D006801:Humans; D007267:Injections; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011460:Prostaglandins F / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012965:Sodium Chloride / Q000627:therapeutic use*; D014592:Uterine Hemorrhage / Q000139:chemically induced; D014839:Vomiting / Q000139:chemically induced
D011460:Prostaglandins F; D012462:Saline Solution, Hypertonic; D012965:Sodium Chloride