INTRAAMNIOTIC PROSTAGLANDIN-F2-ALPHA FOR PREGNANCY TERMINATION IN THE2ND-TRIMESTER AND EARLY 3RD-TRIMESTER OF PREGNANCY

OBJECTIVE: To examine the effectiveness and safety of intraamniotic pr ostaglandin F2 alpha (PGF2 alpha) instillation during second- and earl y third-trimester termination of pregnancy. STUDY DESIGN: The study gr oup consisted of 173 women between 18 and 32 weeks of gestation admitt ed for termination of pregnancy with a live, singleton fetus. The proc edure included intraamniotic instillation of 40 mg PGF2 alpha. In case s of failed induction, after 24 hours an additional procedure (repeate d PGF2 alpha injection, oxytocin augmentation or extraovular balloon i nstallation) was performed. RESULTS: The mean induction-ro-abortion in terval tons 27 +/- 17 hours, 26 minutes. The induction-to-abortion int erval was not significantly influenced by parity, maternal age, indica tion for pregnancy termination or gestational age at the time of the p rocedure. Complications were related to a longer induction-to-abortion interval (35 hours, 41 minutes +/- 26 hours, 15 minutes in complicate d cases as compared to 25 hours, 43 minutes +/- 15 hours, 28 minutes, P = .012). However, complications were uncommon. CONCLUSION: Intraamni otic PGF2 alpha instillation was safely used for termination of pregna ncy, even at advanced gestational ages. The induction-to-abortion inte rval is the main factor influencing complications and is important as a catalyst for cases that fail to abort within 24 hours.