The current status of prostaglandins as abortifacients

Abstract

The present use and potential uses of prostaglandins as abortifacients are summarized. Pertinent history, chemistry, prostaglandins' possible role in physiologic and pathologic processes and pharmacologic actions are discussed. The results of natural prostaglandins and their analogues by systemic and intrauterine administration for the purposes of postcoital contraception, menstrual regulation, first- and second-trimester abortion, preoperative dilation of the cervix, and delivery of patients with death in utero are presented. The only approved method of induction of abortion with prostaglandins, prostaglandin F2alpha by the intra-amniotic route for the induction of midtrimester abortion, is evaluated and compared to other methods of midtrimester abortion. It was concluded that: (1) the present use of prostaglandins is an important addition to the obstetrician's armamentarium, (2) more effective and/or convenient methods that are useful in patients over a wider gestational age appear to have been defined, and (3) the routine use of prostaglandins for postcoital contraception, menstrual regulation, and first-trimester abortion will require the development of analogues that are more specific as to their abortifacient actions than the natural prostaglandins and/or the development of improved delivery systems.

PIP: The present and potential uses of (PGs) prostaglandins as abortifacients are summarized. Pertinent history, chemistry, and the possible role of PGs in physiologic and pathologic processes and pharmacologic actions are discussed. The results of natural PGs and their analogues by systemic and intrauterine administration for the purposes of postcoital contraception, menstrual regulation, first and second trimester abortion, preoperative dilatation of the cervix, and delivery of patients with death in utero are presented. The only approved method of abortion induction with PGs, PGF2alpha by the intraamniotic route for the induction of midtrimester abortion, is evaluated and compared to other methods of midtrimester abortion. It was concluded that: 1) the present use of PGs is important for the obstetrician, 2) more effective and/or convenient methods that are useful in patients over a wider gestational age appear to have been defined, and 3) the routine use of PGs for postcoital contraception, menstrual regulation, and first trimester abortion will require the development of analogues which are more specific as to their abortifacient actions than the natural PGs and/or the development of improved delivery systems.