Midtrimester pregnancy termination for fetal malformations. Use of intravaginal prostaglandin E2.
OBJECTIVE
To compare outcome differences and responses to treatment in pregnancies complicated by either major fetal malformations or previous fetal death in the second trimester.


METHODS
Data were analyzed from a computerized perinatal database and individual hospital records for singleton gestations between 14 and 23 weeks undergoing labor induction with prostaglandin E2 (PGE2) suppositories (20 mg intravaginally every three to five hours).


RESULTS
Between January 1993 and June 1995, 65 pregnancies underwent induction of labor for either a lethal fetal malformation (38) or death (27). As compared with the fetal death group, the malformation group required more suppositories (median 4, range 1-10, versus median 3, range 1-6; P < .05) and needed a greater total dosage (77.5 +/- 38.5 mg versus 61.8 +/- 37.8 mg, P < .05). The mean time from initiation of treatment until delivery was two hours longer in the malformation group. There were no significant differences between the two treatment groups in incidence of maternal side effects or of retained placentas requiring operative intervention.


CONCLUSIONS
Patients who undergo second-trimester induction of labor for major fetal malformations using intravaginal PGE2 should be counseled that the dosage of the drug is greater and that labor may last longer than in pregnancies complicated by a previous fetal death.
Hagar
D L
DL
Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City 73190, USA.
Valley
M T
MT
Rayburn
W F
WF
Carey
J C
JC
D000028:Abortion, Induced / Q000379:methods*; D000328:Adult; D000013:Congenital Abnormalities; D015232:Dinoprostone / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005313:Fetal Death; D006801:Humans; D018457:Placenta, Retained; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D016896:Treatment Outcome
D015232:Dinoprostone