Because of the dangers associated with saline methods, other instillation methods such as hypersomolar urea are sometimes employed,  though these are less effective and usually must be supplemented by oxytocin or a prostaglandin in order to achieve the desired result.  Incomplete or failed abortion remains a problem with urea methods, often precipitating the additional risk of surgery. (6)

As with other instillation techniques, gastrointestinal side effects such as nausea or vomiting are frequent, but the most common problem with second trimester techniques is cervical injuries, which range from small lacerations to complete detachments of the anterior or posterior cervix. Between 1% and 2% of patients using urea must be hospitalized for treatment of endometritis, an infection of the lining oft he uterus

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6. Hern, op. cit., pp. 124-125.