The vaginal administration of 9-deoxo-16,16-dimethyl-9-methylene PGE2 for second trimester abortion

Abstract

9-Deoxo-16,16-dimethyl 9-methylene PGE2 was given as a vaginal suppository at 0 and 8 hours to 37 patients. Two different doses were given, a 75-mg and 60-mg dose. The larger dose achieved an 86% abortion rate at 24 hours and for the smaller dose it was 53%. When an intramuscular injection of 15-methyl PGF2 alpha Tham was added at 24 hours, the success rate was 91% and 80% at 36 hours. The incidence of gastrointestinal side effects were significantly reduced when compared to vaginal administration of either PGE2 or 15-methyl PGF2 alpha methyl ester. The incidence of temperature elevation was similar to that achieved with the use of vaginal PGE2 but higher than with the use of vaginal 15-methyl PGF2 alpha methyl ester.

PIP: A comparative study was conducted to assess the relative efficacy and side effects of 2 dosage schedules using 9-deoxo-16,16-dimethyl-9-methylene PGE2alpha (prostaglandin) for 2nd-trimester abortion. 37 healthy women received the PGE2alpha analog. 22 received an initial 75-mg dose in a vaginal suppository repeated at 8 hours; 15 recived a 60-mg dose which was repeated at 8 hours. If abortion had not occurred at 24 hours, an intramuscular injection of 250 mcg 15-methyl PGF2alpha was administered and repeated at 2-hour intervals for at least 6 injections. The success rate with the 75-mg dose was 86% at 24 and 91% at 36 hours. The mean time for abortion was 14.7 hours with a range of 5.5 to 36 hours. 6 of the women aborted completely and 14 required curettage to complete the procedure. The success rate for the 60-mg dose was 53% at 24 and 80% at 36 hours. The mean time was 21.9 hours with a range of 5.8 to 36 hours. 8 aborted completely and 5 required curettage. The lower dosage required a longer abortion time and produced slightly more side effects. The incidence of gastrointestinal side effects with this method of administration was significantly reduced when compared to vaginal administration of either PGF2 or 15-methyl PGF2alpha methyl ester. All of these PG abortifacients are preferable to saline solution.