Abstract

PIP: This study attempts to modify the prostaglandin method to reduce untoward side effects and to test its acceptability and efficacy. 30 healthy women (20 primigravidas and 10 multiparas) 13 to 36 years old, between the 5th and 21st weeks of gestation participated in the study. Baseline clinical and laboratory data were collected. 12 primigravidas were inserted with 1 to 4 laminaria tents. Ampicillin was administered orally every every 6 hours. 8 primigravidas and 10 multiparas comprised the control group. Ethanol was administered intravenously in all 30 patients. 20 control patients of a following series received 5% dextrose without alcohol. A threshold dose was established at 3 mcg of 15(S)-ME-PGE2 per 100 lbs of body weight. The dose was calculated individually for each patient and injected at 1 hour interval into the deltoid muscle in 17 patients and into the gluteus in 13. The dose was increased by 1 to 2 mcg/hour toward the end of induction. There were no failures: 28 complete abortions (93%) and only 2 incomplete abortions (7%). Mean induction-to-abortion time was 12 hours 14 minutes in multiparas and 18 hours 23 minutes in primigravidas. Use of laminaria tents reduced abortion time for primigravida to 9 hours 29 minutes, which was even shorter than that for multiparas. Mean prostaglandin dose required for complete abortion in all patients was 63 mcg; in multiparas, 61 mcg. Use of laminaria tents halved the total dose needed in primigravidas from 81 to 44 mcg (p 0.05). The incidence of diarrhea in this series was significantly reduced from 3 episodes to 0.9 episode per induction (p 0.05). The results of this study are encouraging and suggest that the prostaglandin derivative may be used intravenously for induction of labor at term.