[Combined pericervical and intramuscular administration of prostaglandin for the termination of pregnancy in the 2d and 3d trimester].

In 64 patients with pathological pregnancies (missed abortion, molar pregnancy, intrauterine fetal death, fetal malformation, maternal disease) termination of pregnancy was induced by local application of PGE2 by means of a portio cap and subsequent intramuscular application of Sulproston. In 21 women 1,5 mg and in 43 2,25 mg PGE2 or more were used for cervical priming. In 21 cases expulsion of the fetus could be obtained during or shortly after the priming procedure. In the remaining 43 women Sulproston was administered on the following day with a starting dose of 200 mcg and 100 mcg subsequently at two hours intervals up to a total dose of 500 mcg. With the exception of 3 cases this led to the expulsion of the products of conception. In the remaining 3 patients abortion was obtained on the third day by additional Sulproston-application. The mean expulsion time was 6,3 +/- 2,1 hours, being significantly lower when the fetus was not alive compared to viable pregnancies. Side effects during the priming procedure were only observed in 3 cases; the total rate of side effects was 57,8% and the incidence of use of analgetics 51,5%. The softening effect of locally applied prostaglandins apparently adds in an advantageous manner to the strong contractile effects of Sulproston resulting in shorter expulsion intervals, lower total dosage of prostaglandins and a reduction of the incidence of side effects and the use of analgetics.