Termination of midgestation pregnancy using laminaria or intracervical prostaglandin E(2) followed by prostaglandin analogues

Abstract

Objective: The optimal regimen of medical termination of the second trimester pregnancy is still under development, but it likely to be characterized by a short induction-to-abortion interval, low incidence of side-effects and high acceptability.

Full Text

Methods: We conducted a prospective, randomized trial to evaluate the efficacy and safety of prostaglandin E₂ and F₂ alpha analogues intramuscular administration for second-trimester abortion in women intracervically pretreated with prostaglandin E₂ (dinoprostone) gel (was given 12 hours before the intramuscular administration of prostaglandins) or one or more medium-thick laminaria tents (were used in a single application for 12 hours).

Results: 250 women requesting termination of second trimester pregnancy were randomized into 4 groups depending on different drug combinations. The mean age and parity of the women and the mean gestational age of the 4 groups were comparable. The median abortion interval was 8.2 hours and the cumulative abortion rates at 24 h was 95%. The total dose of the prostaglandins required to induce abortion and the incidence of side effects or analgesic requirement were significantly less due to cervical priming.

Conclusion: Combination of dinoprostone or laminaria priming of the cervix prior to the synthetic prostaglandin administration is an easy, practical, reliable and safe method of pregnancy termination in midgestation.