Complications
Once in common practice, abortion by intrauterine instillation has fallen out of favor, due to its association with serious adverse effects and its replacement by procedures which require less time and result in less physical discomfort.
Saline is in general safer and more effective than the other intrauterine solutions because it is likely to work in one dose. However, it poses a risk of medical emergency if it enters the blood stream. Prostaglandin is fast-acting, but often requires a second injection, and carries more side effects, such as nausea, vomiting, and diarrhea.
Instillation of either saline or prostaglandin is associated with a higher risk of immediate complications than surgical D&C. Dilation and evacuation is also reported to be safer than instillation methods. One study found that the risk of complications associated with the injection of a combination of urea and prostaglandin into the amniotic fluid was 1.9 times that of D&E.
The rate of mortality reported in the United States between 1972 to 1981 was 9.6 per 100,000 for instillation methods. This is in comparison to rates of 4.9 per 100,000 for D&E and 60 per 100,000 for abortion by hysterotomy and hysterectomy.
There have been at least two documented cases of unsuccessful instillation abortions that resulted in live births.
Read more about this topic: Instillation Abortion