Termination of abnormal pregnancy has long been a major gynecological problem. Both surgical and non-
surgical procedures are associated with a significant risk for both minor and major complications. Treatment with natural
prostaglandins and especially
prostaglandin analogues administered by non-invasive routes seems to be an attractive alternative to methods in current use. In the present study 68 consecutive patients with a
missed abortion or hydatiform mole were treated with
vaginal suppositories containing either 15-methyl-PGF2 alpha methyl
ester or 9-deoxo-16,16-dimethyl-9-methylene
PGE2. When the uterine size at treatment was 13 weeks or less, vacuum aspiration was performed 12 hours after start of
prostaglandin therapy (group I: 41 patients). When the uterus was larger,
curettage was performed only after abortion (group II: 27 patients). In group I approximately 45% of the patients aborted within 12 hours from the start of
prostaglandin treatment. In the remaining patients the cervical canal was sufficiently dilated and the uterus contracted to allow an easy evacuation. In group II all patients aborted within 26 hours from start of
therapy. No serious complications were observed. Both
prostaglandin analogues seemed equally effective in terminating an abnormal pregnancy. The E analogue has the advantage of causing significantly fewer gastro-intestinal side effects than the F analogue, though temperature elevation is more common with the former. It may be concluded that
vaginal administration of
prostaglandin analogues is a simple and effective
therapy for termination of abnormal pregnancy and seems to offer considerable advantages over methods in current use.