Misoprostol for midtrimester termination of pregnancy in women with 1 or more prior cesarean deliveries.

Abstract

OBJECTIVE:

To evaluate the safety and efficacy of vaginal misoprostol for midtrimester termination of pregnancy (TOP) in women with 1 or more prior cesarean deliveries (CDs).

METHODS:

A retrospective study was conducted with 279 women undergoing TOP with vaginal misoprostol between 14 and 26 weeks of gestation. Of these, 193 had no uterine scars (group 1), 60 had 1 prior CD (group 2), and 26 had 2 or more prior CDs (group 3). The primary outcome was the success rate of TOP. Secondary outcomes were time from induction to abortion, total dose of misoprostol used, and occurrence of uterine rupture.

RESULTS:

The success rates were 96.4% in group 1, 81.7% in group 2, and 76.9% in group 3 (P=0.001). Time from induction to abortion, total dose misoprostol, and duration of hospital stay differed significantly among the groups (P=0.001 for all variables). There were 3 cases (11.5%) of uterine rupture in group 3, for an overall rate of 1.1%.

CONCLUSION:

Misoprostol inserted vaginally was effective for midtrimester TOP but the safety of using misoprostol in women with 2 or more prior CDs cannot be confirmed from the present study. Misoprostol should be used carefully, particularly in women with 2 or more prior CDs.

• Authors: Umran Küçükgöz Güleç, Ibrahim F Urunsak, Esra Eser, Ahmet B Guzel, Fatma T Ozgunen, Ismail C Evruke, Selim Buyukkurt
• Journal: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (Int J Gynaecol Obstet) Vol. 120 Issue 1 Pg. 85-7 (Jan 2013) ISSN: 1879-3479 [Electronic] United States
• PMID: 23195293 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Abortifacient Agents, Nonsteroidal
• Misoprostol

Topics

• Abortifacient Agents, Nonsteroidal (administration & dosage, adverse effects)
• Abortion, Induced (methods)
• Administration, Intravaginal
• Adult
• Cesarean Section (adverse effects)
• Cicatrix (etiology, pathology)
• Cohort Studies
• Female
• Humans
• Length of Stay
• Misoprostol (administration & dosage, adverse effects)
• Pregnancy
• Pregnancy Trimester, Second
• Retrospective Studies
• Time Factors
• Treatment Outcome
• Uterine Rupture (etiology)
• Young Adult