Vaginally Administered 16,16-Dimethyl-PGEl-Methyl Ester (Gemeprost) to Induce Termination of Pregnancy after the First Trimester

The results of the first 40 patients, whose pregnancies were terminated using Gemeprost vaginal suppositories are presented. The indication for termination of pregnancy was either fetal abnormality, or fetal death in utero. The mean gestational age was 20.9 +/- 4.4 weeks. 82.5% of patients were delivered within 24 hours, following a mean number of 3.9 +/- 1.3 pessaries. Side-effects were uncommon, and the procedure was well tolerated, with 30% of patients requiring no analgesia, and 60% receiving narcotic analgesia only. The results obtained compare favourably with the overseas experience with this method. Augmentation with oxytocic agents is of questionable value, and routine evacuation of the uterine cavity, under general anaesthesia seems unnecessary. Administration is simple and well tolerated by patients, and this method of pregnancy interruption appears safe, efficient and superior to extra-amniotic infusion of PGF2 alpha.