Which factors influence the number of gemeprost pessaries used in inducing second-trimester abortions?
BACKGROUND
The course of second-trimester abortions with the intention to use gemeprost as the only abortifacient is described.


METHODS
The report is based on 278 consecutive second-trimester abortions, excluding missed abortions, during a 12-year period in a tertiary referral center. The women were treated with 1 mg gemeprost pessaries every fourth hour with a maximum of five applications during 24 h. If abortion had not occurred, a new treatment of gemeprost was prescribed after an interval of 12 h.


RESULTS
The median number of gemeprost pessaries used was 4 (range 1-16) and the mean number (+/-SD) 4.09 (+/-1.90). Abortion occurred within 24 h in 78% of the women and within 48 h in 96%. The efficiency of gemeprost was highly dependent on previous vaginal deliveries (p<0.001), with a mean number of applications of 4.63 (+/-2.04), 3.93 (+/-1.74), and 3.13 (+/-1.26) in those with none, one, and two or more previous vaginal deliveries, respectively. Previous spontaneous abortions were associated with a lower number of applications. Including previous vaginal deliveries and spontaneous abortions in a two-way analysis of variance (anova), only the number of spontaneous abortions was marginally significant (p=0.05). After excluding four patients with three or more spontaneous abortions from the analysis, the number of previous vaginal deliveries was significant (p=0.010) whereas that of spontaneous abortions became nonsignificant. Postprocedure complications were reported in 13% of the women.


CONCLUSIONS
The course of the abortions was dependent on previous vaginal deliveries and spontaneous abortions.
Kaasen
Anne
A
Department of Obstetrics and Gynecology, The National Hospital, University of Oslo, Oslo, Norway. a.kaasen@online.no
Naes
Tormod
T
Haugen
Guttorm
G
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000028:Abortion, Induced; D000328:Adult; D000527:Alprostadil / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D020073:Gravidity; D006801:Humans; D008423:Maternal Age; D010298:Parity; D010570:Pessaries / Q000706:statistics & numerical data*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies
D000020:Abortifacient Agents, Nonsteroidal; C021182:gemeprost; D000527:Alprostadil