Termination of missed abortion and the induction of labor in midtrimester pregnancy

We have confirmed earlier observations, made in laboratory animals and women, that the intra-amniotic injection of hypertonic solution at any time during pregnancy will induce uterine activity terminating in evacuation of the uterus. Our studies were made in 12 patients, 6 with living, midtrimester pregnancies being therapeutically aborted on psychiatric grounds, while 6 had fetal death in utero. The average latent period before abortion or labor commenced was 21.3 hours in the former group of patients, and 14.3 hours in the latter group. All pregnancies terminated spontaneously without the necessity for pharmacologic stimulation. In 6 patients we recorded the intra-amniotic pressure before and after the injection of hypertonic saline and observed the progressive evolution of uterine activity. We believe that this is the first report describing a reliable, safe medical method of terminating missed abortion at any stage of pregnancy.