EFFECT OF INTRAMUSCULAR 15-METHYL PROSTAGLANDIN-F2-ALPHA AFTER 2ND-TRIMESTER DELIVERY

Objective: To determine whether 15-methyl prostaglandin (PG) F-2 alpha shortens the third stage of labor in second-trimester pregnancy loss. Methods: This was a randomized, double-blind, placebo-controlled stud y of women between 13 and 28 weeks' gestation admitted for spontaneous or induced pregnancy termination. Subjects were randomized on admissi on to receive either PG (250 mu g) or placebo (normal saline), 1 mL in tramuscularly every 20 minutes, for a maximum of three doses if the pl acenta had not delivered spontaneously within 10 minutes of the fetus. A dilute oxytocin infusion was given to women in both groups. The pat ients were managed expectantly with hourly vaginal examinations until intervention was required or up to 6 hours, when curettage was schedul ed. Results: Thirty-eight women received PG and 29 received placebo. T here was no difference between the groups with regard to method of pre gnancy termination or gestational age. There was a statistically signi ficant decrease in the time from first injection to placental delivery (40.0 versus 92.5 minutes; P = .02) between the PG and control groups , respectively. Conclusions: The therapeutic use of FG in the third st age of labor in second-trimester pregnancy loss reduces the time to co mplete spontaneous placental delivery. (Copyright (C) 1997 by The Amer ican College of Obstetricians and Gynecologists.)