Methods to determine success of attempts to terminate early gestation pregnancies with prostaglandin vaginal suppositories.
One-hundred subjects received vaginal suppositories containing prostaglandin analogues in order to terminate their pregnancies of 49 days gestation or less. This non-surgical method was successful in 61 subjects, failed in 35 subjects and four subjects were lost to follow-up. Success of prostaglandin therapy cannot be predicted using pretreatment clinical parameters, pretreatment serum beta-hCG levels, or the passage of tissue from the vagina based upon history obtained from the subject. The passage of tissue histologically identified as of fetal origin is a definitive way to determine the success of pregnancy termination but the passage of tissue obtained by history is not. Of the 61 subjects in whom the prostaglandin suppositories were a success, 56 (92%) had a beta-hCG level day 7 +/- 2 following treatment which was 15% or less than the pretreatment value and 5 had beta-hCG levels which were more than 15% of the pretreatment value. All subjects with beta-hCG levels 5 to 9 days after the abortion that were less than 15% of the pretreatment concentrations had a successful termination. Of 35 subjects in whom the prostaglandin suppositories were unsuccessful, 26 had a beta-hCC level 7 +/- 2 days following treatment which was greater than the pretreatment level and 9 had beta-hCG levels less than the pretreatment value. The results of this study indicate that when prostaglandin vaginal suppositories are used to terminate early gestations, if there is no decline in beta-hCG levels 7 +/- 2 days following treatment, the pregnancy should be terminated by another method.
D000028:Abortion, Induced; D000293:Adolescent; D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human; D005260:Female; D005865:Gestational Age; D006801:Humans; D010446:Peptide Fragments / Q000097:blood; D011247:Pregnancy; D011453:Prostaglandins; D013488:Suppositories
D006063:Chorionic Gonadotropin; D018997:Chorionic Gonadotropin, beta Subunit, Human; D010446:Peptide Fragments; D011453:Prostaglandins; D013488:Suppositories