در ختم حاملگي سه ماهه دوم E2 مقايسه اثر شياف واژينال و آمپول پروستاگلاندين

Comparison of vaginal suppository and intravenous PGE2 in termination of pregnancy at midtrimester

Background:There are several methods for abortion either surgical or medical and one of them is the usage of prostaglandins. Objective: Comparison of efficacy of vaginal suppository and IV PGE2 in induction of labor at midtrimester. Methods: This single blind clinical trial was done on 36 pregnant women attending on Kosar hospital in Qazvin during 2002. Indications for termination of pregnancy were reduction of amniotic fluid or intrauterin fetal death. Patients were divided randomly into two equal groups. In first group two suppositories of vaginal PGE2 (3mg) was administered (interval 4 hours). In second group 5 mg of IV PGE2 was applied (diluted in 1000cc 5% dextrose serum) and according to necessity , the dosage of this drug was increased . If abortion did not happen, oxytocin was administered 12 hours Iaer until) abortion occurred. Then results in two groups were compared with T test, and Chi-squre. Findings: Patients of two groups were identical (gestational age, parity , indication of termination). Frequency of abortion before induction in IV PGE2 group was significantly more than vaginal PGE2 groups (14 patients (77.8%) , 2 patients (11.1%) respectively , P<0.0001) .About the changes in Bishop score, amount of applied oxytocin, and the need to curretage after abortin there were no significant differnce between two groups. But duration from induction to expulsion of fetus in IV PGE2 group was significantly less than vaginal PGE2 group (7.3 ± 0.96 hours against 1 1.1 ± 5.6 hours and P=0.019 ). In 2 patients (11.1%) of vaginal PGE2 group and 8 patients (44.4%) of IV PGE2 group drug complication were detected (P = 0.026). Conclusion: Efficacy of IV PGE2 in induction of abortion in midtrimester is better than vaginal PGE2 and it has not serious maternal complications.