Document Detail


Second trimester abortion using prostaglandin E2 suppositories with or without intracervical Laminaria japonica: a randomized study.
MedLine Citation:
PMID:  9721778     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
R O Atlas; J Lemus; J Reed; D Atkins; L S Alger
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  92     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1998 Sep 
Date Detail:
Created Date:  1998-09-24     Completed Date:  1998-09-24     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  398-402     Citation Subset:  AIM; IM    
Affiliation:
University of Maryland Medical Systems, Baltimore, USA. robert.atlas@lvh.com
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MeSH Terms
Descriptor/Qualifier:
Abortion, Induced / methods*
Adult
Cervix Uteri
Dinoprostone / administration & dosage*
Female
Gels
Humans
Laminaria
Oxytocics / administration & dosage*
Pessaries
Pregnancy
Pregnancy Trimester, Second
Chemical
Reg. No./Substance:
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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