Objective: To compare the efficacy, safety, and side effects of intra-amniotic (15S)-15-methyl prostaglandin F2 alpha (15-M-PGF2 alpha) and intravaginal prostaglandin E2 (PGE2) for midtrimester uterine evacuation.
Study design: Ninety-three patients underwent therapeutic midtrimester pregnancy termination by the use of laminaria placement and intra-amniotic injection of 15-M-PGF2 alpha. A matched control group underwent uterine evacuation by laminaria placement and insertion of PGE2 intravaginal suppositories. The main outcomes studied were time to delivery, side effects, and complications.
Results: The 15-M-PGF2 alpha group had a shorter time to delivery (12.3 +/- 6.4 hours) compared with the PGE2 group (16.2 +/- 6.6 hours, p < 0.0001). The evacuation rate over time was significantly greater in the 15-M-PGF2 alpha group (p = 0.001). The PGE2 group had a significantly higher incidence of side effects.
Conclusions: The use of intra-amniotic 15-M-PGF2 alpha for therapeutic second-trimester pregnancy termination is safe and is associated with a more rapid evacuation of the uterus and fewer side effects than intravaginal PGF2 suppositories.