Letter: Convulsions and prostaglandin-induced abortion.

: 615 terminations of pregnancy have been performed in Oxford over a 3-year period with prostaglandins as the prime abortifacient agent; an intravenous infusion of oxytocin was used in 50% of cases. The routes of administration and dose regimen were intraamniotic, extraamniotic, and intravenous. 7 patients had a history of epileptic seizures and were receiving anticonvulsant therapy at the time of admission for termination; this was continued during the abortion procedure. 1 of these patients had fits after admission (but before therapy) and after abortion, but none of the 615 patients had convulsions during the administration of the prostaglandins. 6 of the epileptic group received PGE2 extraamniotically, and the 7th patient PGE2 intraamniotically. Abortion occurred between 7 and 35-1/2 hours. A WHO report quotes trials in 2 university centers of 123 patients treated with intraamniotic PGF2 alpha and 126 patients given intraamniotic hypertonic saline assigned to treatment by random allocation. Convulsions occurred in 1 patient in each group: their previous history is unrecorded. The convulsions reported by Lyneham et al. occurred 7-30 hours after instillation of prostaglandins, which probably precludes the possibility of accidental systemic administration, but which may suggest the involvement of circulating metabolites or endogenous production triggered by abortion processes.