TERMINATION OF 2ND TRIMESTER PREGNANCIES BY SERIAL APPLICATION OF GEMEPROST VAGINAL PESSARIES - A PROSPECTIVE-STUDY

In a prospective study termination of pregnancy was performed between the 16(th) and 24(th) week of gestation by serial applications of a 1 mg gemeprost containing vaginal pessary at 6(h) intervals. The reasons for termination were medical and fetal indications in 20 cases and missed abortion in 14 cases. The median induction to abortion interval was 17,4 hours (range: 3.7-73.0(h)) in the therapeutic abortion group, and a median of 3 applications were necessary to terminate pregnancy. In cases of missed abortion the median induction to abortion intervals was 11.0(h) (range: 3.5-3-2.5(h)) with a median of 2 necessary applications. Expulsion of the fetus occurred in 31 out of 34 patients (91.2%) within 24 hours. Spontaneous or surgically induced cervical lesions and blood loss > 500 ml were not observed, systemic prostaglandin-induced side effects were documented in 7 cases (20.6%). Epidural anaesthesic gave a painless induction of abortion in ail of patients. Our experience has shown that serial application of gemeprost vaginal pessaries is a feasible and efficient method for termination of second trimester pregnancies.