Midtrimester Abortion With Urea, Prostaglandin F_2α, Laminaria, and Oxytocin

A New Regimen

Abstract

This study was undertaken to determine a method of amnio infusion that would 1) produce abortion within 12 hours; 2) be relatively free from risks of coagulapathy and electrolyte imbalance; 3) not result in delivery of liveborns; and 4) incur minimal gastrointestinal side effects from prostaglandin. Patients were randomly assigned to I of 3 groups unless history and examination revealed a contraindication to the use of prostaglandin. Three infusions were used: prostaglandin alone, urea alone, and a combination of urea and prostaglandin. All patients had preinfusion laminaria inserted and all received oxytocin following infusion. There was a significant difference in instillation to abortion time when comparing the three groups and a marked reduction in gastrointestinal side effects using a lower dosage of prostaglandin. The synergistic effect of urea and prostaglandin F_2α previously demonstrated was further enhanced by the use of oxytocin and laminaria. This produced a mean instillation to abortion time significantly shorter than previous studies have shown and, indeed, offers a means of second trimester abortion suitable for use in ambulatory surgery facilities, precluding the high cost of inpatient care.