| Abstract: | The intention of this discussion is to review recent data on prostaglandins and to speculate on their use in clinical obstetrics and gynecology. The uses of prostaglandins are the induction of term labor, therapeutic abortion, and termination of normal and abnormal pregnancies. Prostaglandins E2 and F2alpha have been used successfully to induce labor at or near term. The oral administration of prostaglandins for the induction of labor has been reported by several investigators. Elias concluded that prostaglandins are efficient and safe for the induction of labor in both intravenous and oral forms. Continuous intravenous infusion of either prostaglandins E2 or F2alpha, when administered by the intravenous route, is capable of inducing abortion. Intravenous doses of prostaglandins that will induce abortion are frequently associated with undesirable side effects such as vomiting, diarrhea, and nausea. Due to the severity of the side effects, intravenous therapy is less clinically acceptable and attention has been directed to the vaginal route of administration. The vaginal route of administration can be used to induce abortion in the 2nd trimester with either prostaglandin E2 or F2alpha. The extra-amniotic intrauterine approach has been found to be highly effective, and the rate of abortion has been about 90% within a 36-hour period. The intra-amniotic administration of prostaglandins in 2nd trimester pregnancy compares most favorably with the extra-amniotic intrauterine method and is the only method found to be acceptable in the United States. |
