RANDOMIZED COMPARISON OF PROSTAGLANDIN TREATMENT IN HOSPITAL OR AT HOME WITH VACUUM ASPIRATION FOR TERMINATION OF EARLY-PREGNANCY

The efficacy and the acceptability of vaginal administration of a prostaglandin[PG]E analog (9-deoxo-16,16-dimethyl-9-methylene-PGE2) in hospital or at home were randomly compared with vacuum aspiration for termination of very early pregnancy. Prerequisites for acceptance of the patients were a normal pregnancy, a duration of amenorrhea of .ltoreq. 49 days at least 1 previous full-term pregnancy, and a healthy status. Patients (53) fulfilled these criteria and adhered to the protocol. Seventeen patients were treated with PG at home, 18 with PG in the hospital (9-methylene-PGE2, 50-60 mg twice at 6-h intervals), and 18 with vacuum aspiration. Each patient was interviewed twice by a trained female psychologist before the treatment and 2 wk after. Both the surgical and the nonsurgical methods (at home and in the hospital) were equally effective in terms of frequency of complete abortion. PG therapy was associated with a higher frequency of gastrointestinal side effects, pain, and a longer duration of bleeding than was the surgical procedure. The acceptability study showed that PG treatment was positively received. The patients who were treated with PG remained very positive after the abortion; a majority of these patients intended to use the same procedure in case of a repeated abortion, and would also recommend the treatment to a relative or a friend. Termination of early pregnancy by a medical method, even if self-administered, is an acceptable procedure at least in selected patients.