Termination of 128 Pregnancies in the 2nd Trimester
of Pregnancy by Administration of prostaglandin
15 Methyl F2alpha
Fait T., Calda P., Žižka Z., Pavlišta D., Hrušková H., Živný J.
Gynekologicko-porodnická klinika 1. LF UK a VFN Praha, přednosta prof. MUDr. J. Živný, DrSc. |
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Abstract:
Objective: The critical analysis of the authors’ standard protocol of termination of pregnancy
during the second trimester.
Design: The prospective nonrandomised study.
Setting: Department of Gynecology and Obstetrics, 1 th Faculty of Medicine, Prague.
Methods: We used a synthetic prostaglandin analog carboprost, 15-methyl-prostaglandin F2alpha
for induction of abortion during second trimester. It was administered in a single dose 500 mikro-
grams. It was given into the amniotic cavity through the transabdominal puncture. At the same
time dinoprostonum gel (0.5 mg) was given into vagine. Peridural analgesia has used since begin-
ning of contractions. We investigated indication, mean period of induction, correlation between
the period and indication and week of pregnancy so as a type and number of complication.
Results: From October 1998 till January 2000 128 pregnancy were terminated by intraamniotic
prostaglandins administration. After a single administration 67.2% of women aborted within 24
hours. In 32.8% the intraamniotic administration was repeated twice. The mean induction period,
i.e. the interval between the administration and abortion of the foetus was 28 hours. We didn’t
detect a correlation between the period of induction and the week of gestation or indication.
Complications: A major blood loss replaced by transfusion of erythrocyte mass at 4 cases, a rest
in uterus at 3 cases, once perforation of uterus during revision ot the uterine cavity, once sectiominor for bleeding, once major bleeding conjoined with septic shock, once phlebotrombosis and
at three headache (in connection with peridural analgesia).
Conclusion: The therapeutic effect was achieved in all instances. One case of sectio minor was
connected with strong vaginal bleeding. The method fulfils condition for second-trimester termi-
nation of pregnancy - must be safe, rapid, psychologically feasible and associated with a minimal
risk of long-term consequences. The disadvantage of the method is the price of prostaglandins
and necessity to repeat administration in 32.8% of patients.
Key words:
termination of pregnancy, prostaglandins, second trimester
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