Outcomes of intra-amniotic injection of ethacridine lactate for pregnancy termination in the third trimester or pregnancy termination in women with prior cesarean section

Abstract Background: This study aimed to evaluate the safety and efficacy of the intra-amniotic injection of ethacridine lactate in third trimester pregnancy patients and in patients with a history of cesarean section to induce labor.Methods : This retrospective clinical investigation analyzed 270 patients who underwent second or third trimester pregnancy termination at the affiliated hospital of Guangxi Guilin Medical University between January 1, 2017 and February 29, 2020, including those with and without cesarean section histories. Clinical characteristics and outcomes of all patients were analyzed following treatment with ethacridine lactate.Results: A total of 270 patients were hospitalized for pregnancy terminations, including 234 patients in a second trimester group, 36 patients in a third trimester group, 209 patients in a non-cesarean section group, and 61 patients in a cesarean section group. Among the 270 patients studied, five had twin pregnancies, and eight had two previous cesarean sections. All the included cases had successful vaginal delivery. There was no significant difference in prenatal and postpartum hemoglobin, incidence of massive hemorrhage, the rate of residual placenta and membranes, manual removal of placenta, uterine curettage,and blood transfusion between the second and third trimester groups (P > 0.05), as well as between the non-cesarean and cesarean section groups (P > 0.05). The abortion interval (AI) in the second trimester group was longer than that in the third trimester group (P = 0.014), and the hemorrhage of delivery in the third trimester group was significantly higher than in the second trimester group (P = 0.019). The hemorrhage of delivery in the cesarean section group was higher than that in the non-cesarean section group but displayed no significant difference (P > 0.05). No uterine rupture and placental abruption occurred in any of the patients.Conclusions : Intra-amniotic injection of ethacridine lactate demonstrated good clinical effects and could be used as a suitable method for third trimester pregnancy termination or pregnancy termination in women with prior cesarean sections, and it can also be used to induce labor in the second trimester for twin pregnancies and in patients with a history of two cesarean sections.