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In a multicentre trial 139 women between 15 and 20 weeks of gestation were treated with 2.5 mg intraamniotic administration of 15(S)15 methyl PGF2α (Prostin 15M, Upjohn) for termination of pregnancy. Following treatment 97% of the primigravida and 94.5% of multigravida aborted. The induction abortion interval (Mean ± S.E.M.) in the primigravida was 22.8 ± 1.1 hours, while in the multigravida it was 18.3 ± 1.0 hours. The mean number of episodes of vomiting was 1.4 and 0.9 in primigravidae and multigravidae, respectively. The mean number of episodes of diarrhoea was 0.7 in both groups. Of the primigravidae 10.9% and of the multigravidae 21.7% had incomplete abortions. No injuries to the genital tract were reported.

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The adjunctive use of laminaria tent along with intramuscular 15(S)15 methyl PGF2α (Prostin 15M, Upjohn) was studied for induction of second trimester abortion. Three hundred and two patients from eight centres were recruited for the study. Ninety-two were primigravidae and 210 were multigravidae. One to three laminaria tents were inserted overnight and they were removed before the start of treatment with 250 µg Prostin 15M administered intramuscularly every two hours till abortion. Of primigravida 81.5% and of the multigravidae 79.5% aborted within 24 hours of treatment. The induction abortion interval in the primigravida was 11.2 hours and in multigravidae it was 12.0 hours. The overall incomplete abortion rate was 31.0%. The pimigravidae had higher mean number of episodes of vomiting (2.5) and diarrhea (2.9) than the multigravidae (1.7 and 1.5, respectively). No other complications or injuries to genital tract were reported.

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Transfer of organochlorine pesticides from mother to fetus has been studied in 100 women. The concentrations of organochlorine pesticides were examined in maternal blood, placenta, and umbilical cord blood of the same mother/child pair. Residue levels of dichlorodiphenyl trichloro ethane (DDT) and its metabolites, isomers of benzene, hexachloride (BHC) and aldrin were detected in all the samples analyzed, indicating their transfer from mother to the fetus. A correlation was found to exist between the pesticide concentration and age, dietetic habits and area of residence of pregnant women.

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Umbilical cord blood collected during labor of 100 Indian women was analyzed for organochlorine pesticides by gas-liquid chromatography with electron-capture detection. Significant levels of p,p'-DDT and its metabolites, p,p'-TDE and p,p'-DDE, as well as alpha-, beta-, and gamma-isomers of BHC were estimated. Residues in the neonatal blood were related to age, dietetic habits, and area of residence of the mothers. The study highlights the extent of placental transfer of the body burden of toxic chemicals from the mother to the fetus.

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Organochlorine insecticides (BHC, aldrin, p,p'-DDE, p,p'-DDD, p,p'-DDT) were measured in the blood, placenta and fetus of women experiencing spontaneous abortions, preterm labor or full-term labor using an electron-capture gas chromatographic method. The following trend was found for insecticide concentrations in each of the specimens tested: spontaneous abortions greater than preterm greater than full-term. One conclusion of this work is that the organochlorine insecticides act as antagonists to pregnancy. A plausible explanation for the facilitory role of organochlorine insecticides in the initiation of preterm labor/abortion is hypothesized.

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Premature labour and abortion possibly due to the high concentration of organochlorine pesticides have been investigated. Considerably higher amounts of organochlorine pesticide residues have been detected by gas liquid chromatography in the circulating blood and placental tissue of the women undergoing abortion or premature labour as compared with pregnant women in full term labour. The differences are highly significant for all pesticides estimated.

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A new cervical dilator, Isaptent, was prepared from granulated Plantago ovata (Isapgol) seed husk. It was evaluated in a multicentric clinical trial for dilatation of the cervix in subjects opting for medical termination of pregnancy. The trial covered 804 women in over 21 centres in different parts of the country. The cases were between 15 to 45 years of age, 0 to 10 parity with a gestation period of 8 to 24 weeks. A single tent was used in 750 subjects and satisfactory dilatation was achieved in 94% of the cases. The cervical dilatation bore no relationship to age, parity and gestation period of the subjects. The tent provided self-lubrication, caused no apparent damage to the cervix and the vaginal flora remained unchanged in the randomly selected subjects in whom bacteriologic studies were performed. The outcome of the clinical trial and advantages of Isaptent over the other procedures used for cervical dilatation are discussed.

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PIP: Past research has shown that the method of cervical dilatation is more important in preventing immediate and delayed complications of abortion morbidity than the method of uterine evacuation. An improved method of cervical dilatation has been developed at the Central Drug Research Institute in Lucknow, India. The device, the Isaptent, is a simple and cheap method of insuring a gradual, atraumatic and predictable dilatation of the cervix. Tests of the device with 460 abortions showed its success, which was not associated with the age, parity, or gestation period of the patient. The tent provided selflubrication and caused no damage to the cervix. The advantages of the Isaptent over currently-used methods--metallic instruments, laminaria tents, or prostaglandins--are summarized.^ieng

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