Abstract
A comparative study was conducted to evaluate the effects of repeated, longacting paracervical blocks on the abortifacient efficacy of intraamniotic prostaglandin F2α (PFG2α)—40 mg initially and an additional 20 mg after 24 hours—and hypertonic saline augmented with intravenous oxytocin, for patients at 16 to 20 weeks' gestation. Patients were randomly assigned to the 2 abortion procedures, and one half (50) of the patients induced with each procedure received serial, longacting paracervical blocks. For those patients aborted with saline, the rates of complications, side effects, incomplete abortion, and cumulative abortion were similar for patients whether they did or did not receive paracervical blocks. Among the PGF2α-treated patients who were administered paracervical blocks, there was a significant reduction in the rates of gastrointestinal side effects and incomplete abortion and a significant difference in the cumulative abortion rates. Within 32 hours of the initial PGF2α instillation, 98% of the patients who received paracervical blocks aborted compared to 70% of those who did not receive paracervical blocks. Although the cumulative abortion rates of PGF2α-treated patients with paracervical blocks and saline-treated patients were similar, the rate of incomplete abortion for the PGF2α-treated patients was significantly lower. Additional studies will be necessary to evaluate the safety and advantages of using paracervical block anesthesia as an adjunct to midtrimester abortion procedures.