Title: Prolonged induction to delivery time in termination of pregnancy using 16, 16-dimethyl-PGE1-methyl ester (gemeprost) for fetuses with a neural tube defect or hydrocephalus.

POPLINE Document Number: 121069

Author(s):

Nesbitt D
Giles W

Source citation:

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1996 Aug;36(3):300-3.

Abstract:

Investigated, in this retrospective study, was an observation of hospital staff that use of gemeprost in mid-trimester pregnancy terminations was associated with a longer induction-delivery interval when the fetus had been diagnosed with a neural tube defect or hydrocephalus. The records of a consecutive series of 247 women admitted to Western Suburbs Hospital (Waratah, New South Wales) in the second trimester for gemeprost-induced abortion were reviewed and women were divided into three groups according to indication: Group A (n = 24)--fetal death (not from neural tube defect or hydrocephalus) diagnosed by ultrasound; Group B (n = 88)--all chromosomal and structural abnormalities other than neural tube defect and hydrocephalus; and Group C (n = 75)--neural tube defect and/or hydrocephalus diagnosed by ultrasound. The mean induction interval was 11.3 hours in Group A, 19.7 hours in Group B, and 31.7 hours in Group C. The percentages of women with an induction to delivery interval equal to or exceeding 24 hours were 4.8%, 15.9%, and 43.4%, respectively. The proportion of women requiring further surgical intervention was 4% in Group A, 14% in Group B, and 33% in Group C. These findings should be considered when counseling women who request pregnancy termination for fetal abnormalities. It was hypothesized that fetuses with a neural tube defect or hydrocephalus have a deficiency of the hypothalamic-pituitary-adrenal axis, resulting in decreased corticotrophin-releasing hormone release and difficulty initiating parturition. Use of RU-486, in addition to gemeprost or extra-amniotic prostaglandin, may be indicated in such cases.

Keywords:

Australia
Research Report
Clinical Research
Retrospective Studies
Abortion
Prostaglandins
Time Factors
Fetal Death
Congenital Abnormalities
Genetic Counseling
Developed Countries
Oceania
Research Methodology
Studies
Fertility Control, Postconception
Family Planning
Endocrine System
Physiology
Biology
Population Dynamics
Demographic Factors
Population
Mortality
Neonatal Diseases and Abnormalities
Diseases
Counseling
Clinic Activities
Program Activities
Programs
Organization and Administration