Termination of Pregnancy with Intra-amniotic Hypertonic Saline

Abstract

SummarySuccessful therapeutic abortion was performed consecutively by an intra-amniotic injection of hypertonic saline in 102 out of 110 patients in whom the size of the uterus corresponded with a pregnancy of' 16 weeks or more.A spontaneous abortion of the fetus followed the injection alone in 92 of the cases, and the overall injection-delivery interval was 39-75 (range 11-98) hours. In 10 women intravenous oxytocin injection was used as an additional uterine stimulant because contractions were not established after 48 hours. Complete spontaneous expulsion of the placenta occurred in 71 cases, and evacuation of the placenta under general anaesthesia was required in the other 31.No major complication occurred among the 110 patients.

Amniotic fluid embolism and disseminated intravascular coagulation complicating hypertonic saline-induced abortion

“…Many complications of this technique have been reported: fever and infection (Gillmer, Friend and Beard, 1971;Goodlin et al, 1969;Mackenzie, Roufa and Tovell, 1971;Stim, 1972), haemorrhage (Stim, 1972), coagulation defects (Beller et al, 1972;Brown, Davidson and Phillips, 1972;Goodlin, 1971;Halbert et al, 1972), hypernatraemia (Cameron and Dayan, 1966;Droegemuller and Greer, 1970;Kerenyi, 1969), water intoxication (Abdul-Karim and Assali, 1961;Goodlin, 1971;Whalley and Pritchard, 1963), transplacental haemorrhage (Jorgenson, 1969;Parmely, Montague and Miller, 1970;Voigt and Britt, 1969), retained placenta (Frigoletto and Pokoly, 1971;Futoran, Lowenstein and Peacock, 1969;Kerenyi, 1971) uterine lacerations (Svane, 1960;Wood, Booth and Pinkerton, 1962), and maternal death (Cameron and Dayan, 1966;Goldman and Eckerling, 1972;Pathak, 1968). Amniotic fluid embolism (AFE) is a further possible complication.…”