Kg. Perry et al., Second-trimester uterine evacuation: A comparison of intra-amniotic (15S)-15-methyl-prostaglandin F-2 alpha and intravaginal misoprostol, AM J OBST G, 181(5), 1999, pp. 1057-1061
OBJECTIVE: Our purpose was to compare the efficacy, safety and adverse effe
cts of intra-amniotically administered (15S)-15-methyl-prostaglandin F-2 al
pha and intravaginally administered misoprostol for second-trimester uterin
e evacuation.
STUDY DESIGN: Fifty-one patients were randomly assigned to receive either a
single 2.5-mg intra-amniotic injection of (15S)-15-methyl-prostaglandin F-
2 alpha (n = 26) or two 200-mu g intravaginal doses of misoprostol (n = 25)
at 12-hour intervals. The primary outcome measured was evacuation of the u
terus within 24 hours.
RESULTS: The mean time from initiation of termination to uterine evacuation
was less in the prostaglandin group than in the misoprostol group (17.5 +/
- 8.6 hours vs 22.3 +/- 12.5 hours), but this was not statistically signifi
cant (P > .05). The rate of successful fetal evacuation at 24 hours was sig
nificantly higher in the prostaglandin group than in the misoprostol group
(88% vs 60%, P = .02). The complete-abortion rate and the incidence of adve
rse effects were similar in both groups.
CONCLUSION: The use of an intra-amniotic injection of (15S)-15-methyl-prost
aglandin F-2 alpha for midtrimester pregnancy termination is safe and is as
sociated with a greater number of successful uterine evacuations within 24
hours, without an increase in adverse effects, than intravaginal administra
tion of misoprostol.