Ethacridine lactate -- a safe and effective drug for termination of pregnancy

PIP: In India, physicians analyzed data on 56 women (18-20 weeks gestation) at the Marie Stopes Clinic in Jodhpur who underwent pregnancy termination to evaluate the efficacy and safety of ethacriding lactate which has antiseptic properties. They injected 150 cc 0.1% ethacriding lactate into the intrauterine, extra-amniotic space. They used iv infusion of oxytocin to expedite the delivery of the abortus. 59% of cases were unmarried teenagers. Ethacridine lactate induced successful abortion in 92.8% (52) of cases which was much higher than that found in the literature (about 82%). Abortion failure occurred in the other 4 cases because of transverse lie of fetus (2), cervical dystocia (1), and uterine inertia (1). The transverse lie and cervical dystocia cases would have experienced failure regardless of the uterotonic abortifacient used. 3 of the failure cases underwent evacuation while the other underwent hysterotomy. Most women (73.2%) experienced the abortion 12-24 hours after induction. The mean interval was 20.1 house which was shorter than that of previous reports (29.5-38 hours). The shortest induction-abortion interval was 10.5 hours and the longest was more than 36 hours. Complications occurred in 6 (14.4%) cases. 3 (5.4%) women suffered from cervical tear. 3 (5.4%) women experienced incomplete expulsion which was much lower than that reported in the literature (16-30%). On the other hand, the 5.4% incomplete expulsion rate was higher than that for prostaglandin and hypertonic saline. There was 1 case each of severe bleeding and vaginal laceration. The antiseptic properties of ethacridine lactate likely accounted for the complete absence of sepsis in these women. In conclusion, ethacridine lactate performs better than other instillation abortion methods and it is a safe and effective method.