| Second trimester abortion using prostaglandin E2 suppositories with or without intracervical Laminaria japonica: a randomized study. | |
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MedLine Citation:
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PMID: 9721778 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To compare the abortifacient efficacy of vaginal prostaglandin (PG) E2 suppositories with and without pretreatment with intracervical PGE2 gel and Laminaria japonica. METHODS: One hundred seventy-five women between 16 and 20 weeks' gestation requesting abortion were divided randomly into three groups. Forty-one received PGE2 vaginal suppositories alone to induce abortion, 72 had Laminaria placed 24 hours before vaginal PGE2, and 62 were given intracervical 0.5 mg PGE2 gel plus Laminaria 24 hours before vaginal PGE2. Maternal demographic characteristics, induction to delivery time, number of suppositories required, and complications were analyzed. RESULTS: The mean maternal age, gravidity, parity, race, and gestational age were similar among groups. Ninety-five percent of all women delivered within 24 hours. The induction to delivery time was significantly longer in the PGE2-only women (mean +/- standard deviation 689+/-319 minutes) compared with that of those receiving PGE2 plus Laminaria (487+/-321 minutes) and PGE2 plus Laminaria plus gel (547 +/-374 minutes, P = .01). There was a statistically significant difference in the number of suppositories needed to complete the abortion process. The PGE2-only group required more suppositories (median three, range 1-8) compared with PGE2 plus Laminaria (median 3, range 1-3) and PGE2 plus Laminaria plus gel (median 2.5, range 1-9; P = .001). Patients in the PGE2 plus Laminaria plus gel group reported more pain associated with placement (median pain score 4, range 0-10) compared with PGE2 plus Laminaria (median 2, range 0-9; P = .003). There was a lower incidence of febrile episodes in the PGE2-only group (29%) compared with PGE2 plus Laminaria (68%) and PGE2 plus Laminaria plus gel (54%, P = .002). CONCLUSION: Placement of Laminaria japonica 24 hours before PGE2 vaginal suppository-induced abortion resulted in a significantly shorter induction-to-delivery time, and pretreatment with Laminaria japonica decreased the number of suppositories required to complete abortion. Pretreatment with intracervical PGE2 gel increased pain associated with Laminaria placement and did not improve the efficacy of the procedure. |
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Authors:
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R O Atlas; J Lemus; J Reed; D Atkins; L S Alger |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Obstetrics and gynecology Volume: 92 ISSN: 0029-7844 ISO Abbreviation: Obstet Gynecol Publication Date: 1998 Sep |
Date Detail:
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Created Date: 1998-09-24 Completed Date: 1998-09-24 Revised Date: 2009-10-26 |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 398-402 Citation Subset: AIM; IM |
Affiliation:
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University of Maryland Medical Systems, Baltimore, USA. robert.atlas@lvh.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abortion, Induced
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methods* Adult Cervix Uteri Dinoprostone / administration & dosage* Female Gels Humans Laminaria Oxytocics / administration & dosage* Pessaries Pregnancy Pregnancy Trimester, Second |
| Chemical | |
Reg. No./Substance:
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0/Gels; 0/Oxytocics; 363-24-6/Dinoprostone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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