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  • Title: Therapeutic abortion by intraamniotic injection of prostaglandins.
    Author: Roberts G, Gomersall R, Adams M, Turnbull AC.
    Journal: Adv Biosci; 1973; 9():555-60. PubMed ID: 4805868.
    Abstract:
    This study examines the efficacy of transabdominal intraamniotic injection of prostaglandins (PGs) in therapeutic abortions. Transabdominal amniocentesis was performed under local anesthesia (1% lignocaine) in 27 patients 14-22 weeks pregnant. Uterine activity was monitored. PGF2alpha 25 mg was given as a single intraamniotic injection in the 1st 14 cases. It was given in 3 doses at 24-hourly intervals for 3 successive days in 1 patient. PGE2 was given in 13 patients, 1 mg initially followed by 2 further 1 mg doses at 10-minute intervals. Intravenous oxytocin infusions were used where necessary, as was hysterotomy. Blood samples were collected in 10 patients before and at 4-6 hourly intervals following PGF2alpha administration until abortion occurred, and in 3 patients 40 hours prior to PG administration. A single 25 mg intraamniotic injection of PGF2alpha successfully terminated pregnancy in only 6 of 14 cases. Average-induction delivery interval was 19.52 hours. 6 other patients necessitated intravenous oxytocin infusions to stimulate effective uterine activity; average induction-abortion interval was 59 hours. 2 patients failed to abort, requiring hysterotomy. 7 of 12 vaginally delivered patients had incomplete abortion. Success rate was higher in PGE2-treated patients, with 11 of 13 patients aborting; average induction-delivery interval was 23 hours and 16 minutes. Side effects experienced included severe abdominal pain (for PGF2alpha), vomiting and mild pyrexia (38 degrees Celsius). No consistant change was observed in plasma steroid concentration until after delivery of fetus and placenta occurred. Transamniotic administration of PGE2 appears effective for therapeutic abortion, but not PGF2alpha.
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