Abstract

PIP: A study was conducted in Kamla Raja Hospital, G.R. Medical College, Gwalior, India to evaluate the efficacy of 1% ethacridine lactate and to compare the results with 20% hypertonic saline as abortifacients in midtrimester abortions. The abortions were performed using 1% ethacridine lactate in 65 patients with pregnancies between 12-20 weeks (group A). The patients were admitted to the hospital 1 day before the abortion. In a 2nd group of 65 patients (group B,), the abortion was done using 20% hypertonic saline. In this group oxytocin also was used as it had been with group A patients if the abortion did not occur with 24 hours. The mean induction abortion interval was lower with ethacridine lactate (37.82 hours) than with hypertonic saline (44.40 hours). This interval continued decreasing as the pregnancy advanced -- 12-14 weeks, 42.45 hours; 15-16 weeks, 36.05 hours; 17-20 weeks, 34.96 hours. In the hypertonic saline series, the induction abortion interval continued increasing as the pregnancy advanced -- 12-14 weeks, 44.30 hours; 15-16 weeks, 45.68 hours; and 17-20 weeks, 45.61 hours. With ethacridine lactate the abortion rate (24.62%) was significantly higher within the first 24 hours than with saline (9.23%), although the overall success rate was more with saline (96.92%) than with ethacridine lactate (90.77%). If reinstillation cases were included, the success rate with ethacridine lactate (95.39%) became almost similar to that of hypertonic saline. The complete expulsion rate with ethacridine lactate was only 35.38%, but it was 66.48% with hypertonic saline. The incidence of various side effects, such as headache, rigor, and vomiting, was more with hypertonic saline than with ethacridine lactate. Another advantage of ethacridine lactate was the fact that it can be used safely in patients with cardiovascular and renal diseases. The changes in the maternal coagulation system following intra-amniotic instillation of hyptonic saline, considered to be almost universal, were never encountered in ethacridine lactate induced abortions. Simplicity of technique and equipment required to perform ethacridine lactate instillation is a significant asset for India. Dangers of amniocentesis-like accidental injury to bowel and bladder are never encountered with ethacridine lactate instillation.