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  • Title: Vaginal PGE2 and intraamniotic PGF2 alpha for the termination of second trimester pregnancy.
    Author: Farmakides G, Schulman H, Fayemi A, Fleischer A, Mitchell J, Blattner P.
    Journal: Acta Chir Hung; 1986; 27(3):137-42. PubMed ID: 3469840.
    Abstract:
    A study was conducted in New York City over the September 1982-June 1983 period to examine the role of combinations of intraamniotic instillation of 20 mg prostaglandin E2 (E) and 20 mg vaginal prostaglandin F2 (F) for the termination of 2nd trimester pregnancies. The women seeking abortion were assigned to 1 of 5 treatment methods. The standard procedure included a medical history, physical examination, birth control and abortion counseling, laboratory tests, and a pregnancy sonogram for all participants, who were randomly assigned to the treatment methods. The standard 2nd trimester abortion method used in the Gynecology-Day Hospital of the Bronx Municipal Hospital Center was F 40 mg intraamniotic followed by intravenous oxytocin at 20-30 mU/min approximately 12 hours after the amnioinfusion. This standard method was compared to 4 others in which only 20 mg F was given in association with a 20 mg vaginal suppository of E. Most women receiving E were given lomotil and an antiemetic as prophylaxis against gastrointestinal side effects. The groups were comparable in terms of age and parity. Statistical endpoints used were the P50 cumulative abortion time, the 24 hour cumulative abortion time, and failure rate defined as no abortion in 48 hours. The lowest P50 value was obtained in the EEF group, and there was a significant difference between this group and the FF group. The 24 hour abortion rates were lowest in the EF and the FEE group. The EF group also had the highest failure rate, indicating that the total dosage was inadequate. There were multiple omissions in the recording of side effects, making it impossible to accurately report on whether the incidence of side effects changed with these regimens. On the basis of these results as well as previous data, it is postulated that PGE2 is the better agent for uterine conversion and that PGF2 acts primarily as an oxytocic agent.
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