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  • Title: Second trimester pregnancy termination using extra-amniotic ethacridine lactate.
    Author: Bhathena RK, Sheriar NK, Walvekar VR, Guillebaud J.
    Journal: Br J Obstet Gynaecol; 1990 Nov; 97(11):1026-9. PubMed ID: 2123711.
    Abstract:
    OBJECTIVE: To investigate the efficacy of ethacridine lactate by the extra-amniotic route for second trimester pregnancy termination and its associated complications. DESIGN: Retrospective study of women undergoing second trimester termination, over 3 1/2 years, with extra-amniotic ethacridine alone, or extra-amniotic ethacridine supplemented later by extra-amniotic 15-methyl prostaglandin F2 alpha. SETTING: Teaching hospital in Bombay. PATIENTS: 315 consecutive women undergoing late abortions with extra-amniotic ethacridine. Demographic features were similar in the two groups. INTERVENTIONS: In group 1, 207 women had 150 ml of 0.1% ethacridine lactate injected slowly into the extra-amniotic space. In group 2, 108 women had the initial injection supplemented 6 h later by an extra-amniotic injection of 250 micrograms (1 ml) of 15-methyl prostaglandin F2 alpha. MAIN OUTCOME MEASURES: The occurrence of abortion following the induction procedure. The development of complications such as haemorrhage, infection, or injury to the uterus or cervix. RESULTS: The method was successful in 191 women (92%) in group 1 and in 106 (98%) in group 2. The median induction-abortion intervals were 35 and 19 h, respectively (Mann-Whitney U test, P less than 0.001). The corrected complication rate was less than 10% (30 women), with unplanned uterine evacuation in 6% (20), haemorrhage in 1% (4), and pelvic infection in 4% (14). CONCLUSION: The use of extra-amniotic ethacridine lactate provides an effective and safe treatment method for second trimester legal abortion. The induction-abortion interval can be appreciably reduced by supplementary prostaglandin. This study investigated the efficacy of ethacridine lactate by the extraamniotic route during 2nd trimester pregnancy termination as well as its associated complications. This retrospective study of 315 women undergoing 2nd trimester terminations over a 3 1/2 year period was based at a teaching hospital in Bombay. Patients received either extraamniotic ethacridine alone or supplemented later with extraamniotic 15-methyl- prostaglandin F2alpha (PGF2alpha). Women were divided into 2 groups--in group 1, 207 women received 150 ml of 0.1% ethacridine lactate injected slowly into the extraamniotic space; in group 2, 108 women had the initial injection supplemented 6 hours later by an extraamniotic injection of 250 mcg (1 ml) of 15-methyl-PGF2alpha. Outcome measures which were evaluated were the occurrence of abortion following the induction procedure and the development of complications such as hemorrhage, infection, and injury to the cervix or uterus. The method was successful in 191 women (92%) in group 1 and in 106 (98%) in group 2. The mean induction-abortion intervals were 35 and 19 hours, respectively (Mann-Whitney U test, p0.001). The corrected complication rate was 10% (30 women), with unplanned uterine evacuation in 6% (20), hemorrhage in 1% (4), and pelvic infection in 4% (14). The authors conclude that the use of extraamniotic ethacridine lactate provides an effective and safe treatment method for 2nd trimester legal abortion. The induction-abortion interval can be appreciably reduced by supplementary PGs.
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