Intraamniotic 15(s)-15-methyl prostaglandin F2-alpha and termination of middle and late second-trimester pregnancy for genetic indications: a contemporary approach

A synthetic analog of prostaglandin F2-alpha used in combination with urea and cervical laminaria appears to be a safe and effective technique for inducing second-trimester abortions. Sixty-two women having abortions because of fetal genetic abnormalities were treated with 2.0 milligrams of intra-amniotic 15(s)-15-methyl prostaglandin F2-alpha after injection of 80 grams of urea. Laminaria was used to aid cervical dilation. Gestational age at the time of abortion was 16 to 27 weeks. The majority of patients delivered within six to 12 hours of beginning the abortion procedure. Vomiting and diarrhea were the most common side effects. There were five cases of delayed complications including bleeding from a cervical laceration and continued bleeding necessitating curettage. Three additional patients developed infections that were treated with antibiotics. Complications were similar to those experienced by women who had abortions induced with urea and laminaria followed by vaginal prostaglandin suppositories.