Midtrimester abortion by dilatation and evacuation versus intra-amniotic instillation of prostaglandin F2 alpha: a randomized clinical trial

Abstract

To compare the safety and feasibility of midtrimester abortion by outpatient dilatation and evacuation (D-E) versus inpatient intra-amniotic instillation of prostaglandin F2 alpha (PGF2 alpha), we performed a randomized clinical trial with 100 subjects estimated to be 13 to 18 menstrual weeks pregnant. Subjects undergoing D-E abortion had significantly better compliance with the assigned treatment (100% vs. 88%, < 0.05) and less delay prior to abortion (mean 3.7 vs. 10.1 days, p < 0.001). Subjects receiving PGF2 alpha had a relative risk of sustaining a complication 5.7 times that of subjects undergoing D-E (95% confidence interval 2.1-15.3, p < 0.001). Subjects receiving PGF 2 alpha also had significantly higher rates of vomiting and diarrhea (p < 0.01). Midtrimester abortion by outpatient D-E appears to be more acceptable to women, faster, and safer than by instillation of PGF2 alpha.

PIP: 100 subjects comprised a randomized clinical trial to compare the safety and feasibility of 2 methods of midtrimester abortion. Outpatient (D-E) dilatation and evacuation and inpatient intraamniotic instillation of (PGF2alpha) prostaglandin F2alpha were the 2 methods utilized on these subjects estimated to be 13-18 weeks pregnant. Subjects undergoing D-E abortion had significantly better compliance with the assigned treatment (100% vs. 88%, P 0.05) and less delay prior to abortion (mean 3.7 vs 10.1 days P 0.001). Subjects receiving the PGF2alpha had a relative risk or sustaining complications 5.7 times that of subjects undergoing the other procedure (95% confidence interval 2.1-15.3, P 0.001). The subjects receiving the PGF2 alpha also had significantly higher rates of vomiting and diarrhea (P 0.01). Midtrimester abortion by outpatient D-E is proven faster, safer, and more acceptable to women than PGF2 alpha instillation.