Menstrual regulation by intramuscular injections of 16‐phenoxy‐tetranor PGE2 methyl sulfonylamide (sulprostone). A multicentre study

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Abstract
Summary. In a previous study we have shown that three intramuscular injections of 0·5 mg of the prostaglandin analogue, sulprostone (16‐phenoxy‐W‐17,18,19,20‐tetranor PGE2 methyl sulfonylamide), were equally effective as vacuum aspiration for menstrual regulation in women with a delay of up to 21 days in the onset of expected menses. To assess whether lower doses of the prostaglandin could be effective if treatment were restricted to women with a delay of menses of up to 14 days, a multicentre trial investigated the effect of two injections of 0·25 mg sulprostone given with a 4‐h interval. After an interim analysis showed a clinically unacceptable low rate of complete abortion (41%) amongst the 64 pregnant women thus treated, the dose was doubled to two injections of 0·5 mg. In the group of 51 pregnant women treated with the increased dose, the frequency of complete abortion (67%) was significantly higher although still well below the 91% success rate achieved in our previous study. Both the duration and the subjective vaginal blood loss were greater in women with complete abortion than in those with incomplete abortion or continuing pregnancy. It is concluded that the sulprostone dose used in our previous study (3×0·5 mg) represents the minimal, required dose for menstrual regulation.