Evaluation of efficacy of use of intracervical Foley’s catheter with PGE1 vaginal tablet versus intracervical Foley’s catheter with extra-amniotic instillation of PGF2 alpha for second trimester abortion

Background: Termination of pregnancy in second trimester and more so in women with scarred uterus is a real challenge and leads to three to five times higher risk of maternal morbidity and mortality.Objective: Compare effectiveness of Foley's catheter balloon and PGE2 vaginal tablet versus Foley's catheter balloon and extra amniotic instillation of PGF2 in termination of second trimester pregnancy.Method: Prospective study, done in the department of obstetrics and gynaecology, KGMU, Lucknow.Total of 40 patients, 20 in each group, fulfilling inclusion and exclusion criterion were recruited by simple random allocation.Group A patients were induced with Foley's catheter balloon plus vaginal PGE2 tablet, group B induced with Foley's catheter balloon with extra amniotic instillation of PGF2.One injection of PGF2 1ml (5mg) was diluted with 19 ml of normal saline making 2ml of the solution equal to 0.50 mg of PGF2, 2ml was injected one hourly till the expulsion or till 48 hours have passed.Patients were observed for induction to expulsion interval.Data collected was statistically analysed.Results: Mean induction to products expulsion interval was significantly shorter in the group B as compared to group A (18.44 versus 26.28.4hrs, p<0.005).16 patients out of 20 in group B expelled with one ampoule and within 24 hours. Conclusion:The combined use of Foley's catheter balloon with extra amniotic instillation of PGF2 is safe and effective method for second trimester termination.