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Intra-amniotic Instillation of Hyperosmolar Urea and Prostaglandin F2 v Dilatation and Evacuation

Michael E. Kafrissen, MD, MSPH; Kenneth F. Schulz, MBA; David A. Grimes, MD; Willard Cates, Jr, MD, MPH

JAMA. 1984;251(7):916-919.

Abstract
Although dilatation and evacuation (D&E) is currently the most common method of midtrimester abortion in the United States, the intra-amniotic instillation of hyperosmolar urea and prostaglandin F₂ combined (U-P) has been proposed as a safer technique. To evaluate the comparative safety of U-P and D&E, we analyzed 2,805 U-P and 9,572 D&E abortions at 13 to 24 menstrual weeks' gestation. The U-P procedure resulted in significantly more serious complications than D&E (1.03 v 0.49 per 100 abortions). After adjusting for patient age, race, parity, follow-up information, and preexisting conditions, the relative risk of serious complications associated with U-P was 1.9 (95% confidence interval, 1.2 to 3.1). This advantage for D&E stems from its applicability to the 13- to 16-week interval. Although D&E appears to be safer overall in the midtrimester, for women obtaining abortion after 16 weeks, the rates of serious complications were comparable, with a relative risk of 1.0 (95% confidence interval, 0.4 to 2.5).

(JAMA 1984;251:916-919)

Author Affiliations
From the Division of Reproductive Health, Center for Health Promotion and Education, Centers for Disease Control, Atlanta.

Footnotes
Reprints not available.

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