A Amirabi [1] , MD S Golmohammadlou [2] , MD S Salari lak [3] , Ph.D L Khabiry [4] , MD

 Received: 29 April, 2008 Accepted: 6 Aug, 2008

 Abstract

 Background &Aims: It is necessary to terminate pregnancy for fetal or maternal indications in some second trimester pregnancies. The cervix is usually unripe in 2^nd trimester, so pre-induction ripening is mandatory. The aim of this study is to compare the efficacy of extra-amniotic saline infusion with prostaglandin E2 suppository in pre-induction cervical ripening in 2^nd trimester pregnancies.

 Materials & Methods: In this study, women (n= 80) with indications of termination of pregnancy (range 14-28 weeks) and bishop scores of 3 and lower were assigned randomly to receive extra-amniotic saline infusion (2ML/ min) or prostaglandin suppository (6mg).We induced uterine contractions using intravenous oxytocin only when contractions had not commenced by 6 hours after extra-amniotic saline infusion and 4 hours after prostaglandin. We assessed ripening efficacy, success and failure of therapy, mean time of induction, and complications of two methods. Statistical analysis was done based on the data.

 Results: The mean pre-ripening bishop score was l.2±0.53 in group 1 (extra-amniotic saline infusion) and 1.68±0.66 in group 2 (prostaglandin). The mean post- ripening BSC was 4.5±2.14 in group I and
3 ± 1.6 in group 2, which was significant. There were 20 (%50) fetus expulsion in group 1 and 8 (20%) in group 2. The mean time for induction was 17.27 ± 8.38 hours in group 1 and 20.9 ±6.17 hours in group 2, which was statistically significant. One patient in group 1 had vaginal bleeding because of warfarin use. Three patients had nausea in group 2. There were no other complications in both methods.

 Conclusion: Cervical ripening by extra-amniotic saline infusion is faster and more effective than 6 mg prostaglandin E2 suppository, resulting in a higher rate of fetus expulsion in 2^nd trimester.

 Keywords: Second trimester pregnancies, Extra-amniotic saline infusion, Prostaglandin E2 suppository, Using intravenous oxytocin, Cervical ripening

  Address: Obstetrics and Gynecology Department, Kosar Hospital, Urmia, Iran Tel: 09141416846

  E-mail: amirabi@umsu.ac.ir

  Source: UMJ 2009: 19(4): 357 ISSN: 1027-3727