AbstractsIt has been suggested that prostaglandin treatment might terminate some ectopic pregnancies. The present authors have previously analyzed the influence of various prostaglandins on smooth muscle of the human fallopian tube, including the blood vessels. Their results clearly demonstrate that prostaglandin F compounds, in contrast to other prostaglandins, invariably cause powerful contractions. Moreover, data from in vitro experiments on the human corpus luteum provide evidence of antigonadotropic action of prostaglandin F2α.Together, these experimental data indicate that prostaglandin F compounds could be useful in the treatment of selected cases of ectopic pregnancy. The authors report a test of this hypothesis in clinical practice.Nine patients (ages, 25–35 years) with ectopic pregnancies were selected for the study. Five of the pregnancies were situated in the right tube, and four were situated in the left tube. A corpus luteum of pregnancy was identified on the contralateral side in each of two patients and on the ipsilateral side in each of the remaining seven. All of the pregnancies had ampullary locations.Routine diagnostic laparoscopy was performed, with confirmation of the diagnosis according to established criteria. The affected oviduct and ovary were grasped and made accessible with 5-mm atraumatic forceps. A 15-cm injection needle with an outer diameter of 0.8 mm was introduced through the lower abdominal wall under laparoscopic guidance. The tip of the needle was inserted into the tubal wall over the ectopic pregnancy. Prostaglandin F2α(five cases, 0.5–1.5 mg) or 15-methyl-prostaglandin F2α(four cases, 75 μg) diluted in 3 to 10 ml of physiological saline was then gently injected, causing visible swelling of the tubal wall. In each patient except one, an identical dose of prostaglandin F2αwas injected subcapsulariy into the ovary containing the corpus luteum. After completion of the injections, visible blood and blood clots were evacuated from the pouch of Douglas by suction and irrigation. In six patients, serum hCG was measured more than once before the operation. All patients had serial determinations postoperatively.Nine patients underwent the procedure without any untoward reaction during or after operation and were discharged 1 to 2 days later. One woman had a second laparoscopy and injection of prostaglandin F2α(14 days after the first operation and injection) because her serum hCG had not declined sufficiently. The remaining eight resumed normal activities within 10 days.