Aborteinleitungen im zweiten und dritten Trimenon mit »Sulproston«

Abstract

Report on 114 terminations of pregnancy during the second and third trimester of pregnancy with a new prostaglandin E2 derivative "Sulprostone". In 84 cases legal therapeutic abortions were induced. In 30 women an abnormal pregnancy was terminated. "Sulprostone: is a prostaglandin with selective activity in the uterus. It can be administered parenterally or locally. 48 women received intravenous sulprostone, 35 patients had extraamniotic injections and 31 patients had extra-amniotic injections following an intramuscular injection for priming of the cervix the night before. In 103 women the pregnancy was terminated within the first 24 hours after the administration of sulprostone (90.3%). 8 patients (7.0 %) had a cervical dilatation over 2 cm. In 3 women no effect was noted. In 1 patient the prostaglandin application was stopped because of severe vomiting. The mean administration abortion interval was 12 hours and 54 minutes following extra amniotic application and 10 hours and 30 minutes with extra amniotic application and following intramuscular priming. In 5 patients the abortion was completed after the priming administration. More than 90% of the patient's required analgesia. There were 32.4% side effects of mild character. The results and the methods are described and compared to other methods.

Morbidität einzeitiger Abortausräumungen im 2. Trimenon: Eine Standortbestimmung

“…Nach intrazervikaler Prostaglandin-E 2 -Applikation sind Zervixverletzungen infolge des Primingeffekts sehr selten; Stampe Sorensen et al [33] und Herabutya und Israngura Na Ayudthaya [2] wiesen in ihren Untersuchungen keine Zervixverletzungen nach, Schmidt und Ditz [34] registrierten lediglich bei einer Patientin eine Läsion der Zervix. Zervixverletzungen wurden in Einzelfällen auch bei der extraamnialen Prostaglandin-E 2 -Applikation beschrieben [25,26,28,30,32,35]. Bei D&C hingegen resultieren Zervixverletzungen häufig aus einer forcierten und zu raschen Dilatation des Zervikalkanals mit Hegar-Stiften bei unreifer Portio oder -was in unserer Gruppe die Hauptursache war -aus dem Ausreissen der Kugelfasszangen.…”

Preoperative Administration of Prostaglandin to Avoid Dilatation-Induced Damage in First-Trimester Pregnancy Terminations

“…However, when it was observed that the oxytocic effect was complemented by cervical dilatation in induction of second-trimester abortions, it was natural to consider exploiting this cervical and softening effect in first-trimester terminations as well. Thus, an attempt was made to replace mechanical dilatation by a chemistry-based method, in our case by prostaglandin (5,11).…”