Comparison of Extra-Amniotic Normal Saline Infusion plus Hydrocortisone versus Prostaglandin E2 Suppository for Pregnancy Termination

Pregnancy termination before onset of labor is one of the midwifery problems. The aim of the present study was to compare extra-amniotic normal saline infusion plus hydrocortisone effect versus prostaglandin E2 suppository for cervical ripening and second- trimester pregnancy termination. This randomized clinical-trial study was performed on 50 pregnant women with gestation age of 14 to 28 weeks and Bishops Score ≤ 2 who required pregnancy termination for fetal indications. Half of the cases received extra-amniotic normal saline infusion plus 100 mg hydrocortisone (EASI+ H) and the other half received two doses of 3mg prostaglandin E2 suppository every 4 hours. Six hours later، induction of labor was started by means of a high dose of Oxytocin according to of Alabama University Protocol for Mid-trimester Abortion. The obtained data was analyzed by using statistical softwares Chi-square، Fisher and T-test. There were no differences between the two groups regarding maternal age، parity، gestational age، Primary Bishops Score and indication of pregnancy termination. In the EASI+H group، the mean interval between initiation of labor induction and fetal expulsion was 23. 04 ± 4. 47 hours and in PGE2 group was 28. 65 ± 2. 87 hours (P=0. 001). The success rate in the EASI+H group was 100% and in PGE2 group 80 % (P =0. 04). Complications such as fever، nausea، vomiting، diarrhea، increase of blood pressure and need to curettage in PGE2 group were statistically and significantly more abundant. Extra-amniotic normal saline infusion plus hydrocortisone is an effective and safe method that is suggested for cervical ripening and second- trimester pregnancy termination.