These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: [Termination of pregnancy in the 2nd trimester using intra-amniotic administration of prostaglandins].
    Author: Krofta L, Calda P, Zizka Z, Parízek A, Hrusková H, Kapras J.
    Journal: Ceska Gynekol; 1998 Oct; 63(5):414-7. PubMed ID: 9818502.
    Abstract:
    INTRODUCTION: The method used to terminate pregnancy on medical grounds during the second trimester must be safe, rapid, psychologically feasible and associated with a minimal risk of long-term sequelae. The objective of the present work was a critical analysis of the author's standard protocol of termination of pregnancy during the second trimester. MATERIAL AND METHODS: For induction of abortion during the second trimester the authors used a synthetic prostaglandin analogue (PG) F2 alpha-Dinoprost which was administered in a single dose of 30 mg by the intraamniotic route. At the time of onset of uterine contractions the authors administered peridural anaesthesia. The authors investigated indications, mean period of induction, correlation between the period of induction of abortion and the indications for termination of pregnancy, the week of pregnancy and parity of the mother. They recorded also the type and number of complications. RESULTS: From January 1991 till June 1997 179 pregnancies were terminated by intraamniotic PG administration. After a single intraamniotic PG administration 72% women aborted within 24 hours. In 26% women the intraamniotic administration was repeated twice and in 2% women three times. The mean induction period, i.e. the interval between the administration and abortion of the foetus was 22.6 hours. The interval was significantly longer (28 hours) in foetuses where pregnancy was terminated because of a neural tube defect (p < 0.01). The authors did not detect a correlation between the period of induction and the indication, week of gestation and parity of the mother. COMPLICATIONS: once a general reaction to intraamniotic administration, in three patients a major blood loss replaced by transfusion of erythrocyte mass, no uterine rupture. CONCLUSION: In all instances the therapeutic effect was achieved and there was no need to perform section minor. The disadvantage of the method is the high price of the preparation and need of repeated intraamniotic administration of PG in 29% of the patients. In this study F2 alpha-Dinoprost, a synthetic prostaglandin analogue, was tested for use in inducing abortion in second-trimester pregnancy. During the period of January 1991 to June 1997 a total of 179 pregnancies were terminated by intra-amniotic administration of the drug. The indications for the fetus were congenital abnormalities (59 cases or 32%), intrauterine death (41 cases or 24%), and chromosomal aberrations (20 cases or 11%). For the mother the indications were internal disease, psychological reasons (38 cases or 21%), and unsuccessful abortion in the first trimester. The following procedure was carried out: puncture of the amniotic sac under ultrasound control, intra- amniotic administration of a 5 mg of Dinoprost test dose followed by the whole single dose of 30 mg, continuous infusion of 5 mg of Dinoprost at a speed of 10 gtt/min, peridural analgesia, and instrumental curettage. Peridural anesthesia was administered at the time of onset of uterine contractions. Following a single dose 72 women aborted within 24 hours. The intra-amniotic administration of the drug was performed twice in 48 (26%) women and three times in 3 (2%) women. The mean induction period (the interval between dose administration and the expulsion of the fetus) was 22.6 hours. The interval was significantly longer (28 hours) in fetuses for which pregnancy was terminated because of a neural tube defect (p 0.01). Complications included 1 episode of general reaction to intra-amniotic administration; in 3 patients massive blood loss was replaced by the transfusion of 2 x 300 ml erythrocyte mass. Postabortum residue was encountered in 2 cases, cervical rupture in one case, and phlebothrombosis in 1 case. The disadvantage of the method is the high price of the preparation and, to judge by these results, that it requires repeated administration for a substantial minority (29% or 51) of patients.
    [Abstract] [Full Text] [Related] [New Search]