Induction of midtrimester abortion with intraamniotic urea, intravenous oxytocin and laminaria.

Midtrimester abortion was accomplished in 75 patients by the intraamniotic instillation of 80 g of urea and the intravenous administration of oxytocin. In 33 of the patients, laminaria tents were inserted into the cervix. No severe complication occurred; all fetuses were stillborn. A single urea instillation was effective in 94.6% of the patients. The mean instillation-abortion interval was significantly (p less than 0.02) shorter in patients with laminaria tents than in those without. The tents probably prevent cervical rupture in s-me patients. Significant but transient changes occurred in platelet count and blood urea nitrogen one hour after urea instillation. Surgical removal of the placenta was required in 18.7% of the 75 patients; infection occurred in 2.6%. The combined use of urea, oxytocin, and laminaria appears to be an effective and relatively safe method of inducing abortion during the second trimester.