Second trimester pregnancy termination in primigravidas by double application of dinoprostone gel and intramuscular administration of carboprost tromethamine.

Klinika za ginekologiju i akuserstvo, Medicinski fakultet, Novi Sad. ginvuk@eunet.yu

A randomized study of legal pregnancy termination in the second trimester has been performed in primigravidas by endocervical application of Prepidil gel (dinoprostone gel) in combination with intramuscular application of Prostin 15 M (carboprost tromethamine). The study comprised 97 patients. The control group (N = 35) included patients in whom pharmacologic preparation of the cervix was performed by a singleton endocervical application of 0.5 mg dinoprostone gel and intramuscular administration of Prostin 15 M (Carboprost Tromethamine) (1 ml/2 h) 10 h later and until abortion. The investigated group A (N = 31) underwent pharmacologic preparation of the cervix by endocervical application of 0.5 dinoprostone gel, 2 times during an interval of 4 hours. Intramuscular injection of Prostin 15 M (Carboprost Tromethamine) (1 ml/h) was administered 6 hours after the second application of gel and until abortion. The investigated group B (N = 31) underwent pharmacologic preparation of the cervix by a singleton double-dose endocervical application of 0.5 mg dinoprostone gel and intramuscular treatment by 1 ml/2 h of Prostin 15 M (Carboprost Tromethamine) applied 10 hours later and until abortion. On the basis of obtained results, a conclusion was made that the NEW combination of endocervical and intramuscular application of prostaglandins gives statistically significantly shortened abortion interval (the control group x = 9.97; SD = 5.22 versus investigation group: A-x = 6.80; SD = 4.31 and investigation group: B-x = 5.55; SD = 3.48). Better pharmacologic preparation of the uterine cervix resulted in shorter abortion interval and decreased amount of systemically applied prostaglandins. A shortened abortion interval significantly decreases the rate of immediate, early and late complications. A decreased amount of systemically applied prostaglandins results in significantly lower rate of unwanted side-effects caused by prostaglandins, making this method of pregnancy termination significantly cheaper.

PMID: 11436877 [PubMed - indexed for MEDLINE]