title: Termination of third-trimester pregnancy before term with gemeprost vaginal pessaries.
abstract: OBJECTIVE
  Determination of the efficacy and side-effects of the synthetic prostaglandin analog gemeprost for termination of pregnancy in the third trimester.
  
  
  METHODS
  Retrospective record study of 40 women who had undergone third trimester termination of pregnancy before term by serial administration of gemeprost because of intrauterine fetal death or hopeless fetal prognosis. Patients with multiple pregnancy, a Bishop score > 5, contractions or contraindications to prostaglandins were excluded.
  
  
  METHODS
  Gemeprost vaginal pessaries (1-mg) were given at 6-hourly intervals until labor intervened. The main parameter studied was the induction-delivery interval, the length of time between administration of the first dose and delivery. Statistical analysis was performed with the chi-square and the Mann-Whitney U-test.
  
  
  RESULTS
  The median induction-delivery interval was 14.4 h (range 3-48 h). Delivery occurred within 12 h in 17 women (42.5%), within 24 h in 27 women (67.5%) and within 36 h in 37 women (92.5%). An average of 2.6 doses were given per patient. Multigravidae had a significantly shorter induction-delivery interval than primigravidae (p < 0.01). A total of 87.5% women required analgesia. Side-effects were infrequent.
  
  
  CONCLUSIONS
  The administration of gemeprost vaginal pessaries represents an efficient method with few side-effects for the induction of labor in the third trimester, provided patients are chosen carefully and monitored closely.
authors.affiliation: Department of Obstetrics and Gynecology, Julius Maximilian University, Würzburg, Germany.
authors.forename: Torsten
authors.initials: T
authors.lastname: Frambach
authors.forename: Thomas
authors.initials: T
authors.lastname: Müller
authors.forename: Silke
authors.initials: S
authors.lastname: Blissing
authors.forename: Marc
authors.initials: M
authors.lastname: Sütterlin
authors.forename: Johannes
authors.initials: J
authors.lastname: Dietl
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage* / Q000009:adverse effects; D000028:Abortion, Induced / Q000706:statistics & numerical data*; D000282:Administration, Intravaginal; D000328:Adult; D000527:Alprostadil / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D005313:Fetal Death; D005858:Germany / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D008499:Medical Records; D010570:Pessaries; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; C021182:gemeprost; D000527:Alprostadil