Experience with midtrimester abortion

Abstract

The midtrimester abortion program at a large community hospital was evaluated. During the 3-year study, 1839 patients aborted in the midtrimester by intraamniotic injection of hypertonic saline, prostaglandin F2alpha or a combination of saline and prostaglandin F2alpha. The method, using a combination of saline and prostaglandin F2alpha together with intracervical laminaria, showed significant reduction in the number of failures (4.3 to 1.0%), reduction in the injection-abortion interval from 33.9 to 14.6 hours, shortening of the hospital stay from 2 1/2 to 1 1/3 days, minimum incidence of live abortions (0.9%), infrequent need for oxytocin to effect delivery (7.7%); and low rates of hemorrhage (1.5%) and fever (2.8%). The main disadvantage was an increased rate of incomplete abortions (32.3%), which could be reduced to 27% by patient selection.

PIP: A retrospective study was performed of all patients undergoing midtrimester abortion at the Baystate Medical Center from 1975-1977 (1839 patients). A comparison was made of the 3 methods employed: intraamniotic hypertonic saline, intraamniotic prostaglandin F2 alpha, and a combination of intraamniotic hypertonic saline and prostaglandin F2 alpha. It was found that use of the combination method resulted in significantly fewer failures and a significantly lower injection-abortion interval (from 33.9-14.6 hours) which resulted in a shorter hospital stay. In addition, the combination method resulted in fewer reinjections (as did use of hypertonic saline alone) than use of prostaglandin alone and less frequent use of oxytocin for delivery. The rate of live abortion was .2% for saline, 9% for prostaglandin alone, and .9% for the combination method. The side effects of hemorrhage and fever occurred in 2.8% and .2% of the patients who underwent the combination procedure, respectively.