Comparison of intra-amniotic (15S)-15-methyl-PGF2 alpha and intravaginal prostaglandin E2 for second-trimester uterine evacuation.
OBJECTIVE
To compare the efficacy, safety, and side effects of intra-amniotic (15S)-15-methyl prostaglandin F2 alpha (15-M-PGF2 alpha) and intravaginal prostaglandin E2 (PGE2) for midtrimester uterine evacuation.


METHODS
Ninety-three patients underwent therapeutic midtrimester pregnancy termination by the use of laminaria placement and intra-amniotic injection of 15-M-PGF2 alpha. A matched control group underwent uterine evacuation by laminaria placement and insertion of PGE2 intravaginal suppositories. The main outcomes studied were time to delivery, side effects, and complications.


RESULTS
The 15-M-PGF2 alpha group had a shorter time to delivery (12.3 +/- 6.4 hours) compared with the PGE2 group (16.2 +/- 6.6 hours, p < 0.0001). The evacuation rate over time was significantly greater in the 15-M-PGF2 alpha group (p = 0.001). The PGE2 group had a significantly higher incidence of side effects.


CONCLUSIONS
The use of intra-amniotic 15-M-PGF2 alpha for therapeutic second-trimester pregnancy termination is safe and is associated with a more rapid evacuation of the uterus and fewer side effects than intravaginal PGF2 suppositories.
Perry
K G
KG
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson 39216-4505, USA.
Roberts
W E
WE
Martin
R W
RW
Magann
E F
EF
Sullivan
D L
DL
Morrison
J C
JC
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage* / Q000627:therapeutic use; D000028:Abortion, Induced / Q000009:adverse effects / Q000379:methods*; D000282:Administration, Intravaginal; D000650:Amnion; D002260:Carboprost / Q000008:administration & dosage* / Q000627:therapeutic use; D004107:Dilatation and Curettage; D015232:Dinoprostone / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007267:Injections; D018457:Placenta, Retained / Q000601:surgery; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D013488:Suppositories
D000020:Abortifacient Agents, Nonsteroidal; D013488:Suppositories; D002260:Carboprost; D015232:Dinoprostone