Iraqi Journal of Medical Sciences








Vol. 12 Issue 3 July - September / 2014
Published on website | Date : 2016-03-24 10:15:13

VAGINAL MISOPROSTOL FOR SECOND TRIMESTER PREGNANCY TERMINATION IN WOMEN WITH PRIOR ONE CAESAREAN DELIVERY

Enas A.A. Al-Kazaaly


Abstract

Background :Misoprostol, a synthetic prostaglandin analogue, has become the leading mean for terminating the pregnancy. It is not clear, however, whether misoprostol is a safe abortifacient after thirteen weeks gestation in women who have a uterine scar from a previous lower segment caesarean delivery.
Objective:To evaluate the efficacy and maternal side effects of misoprostol used vaginally for second trimester termination in women with a single previous lower segment caesarean delivery.
Method:Sixty participants with a history of previous one lower segment caesarean delivery underwent pregnancy termination for missed abortion or lethal fetal anomaly between 14-28 weeks gestation using intra vaginal misoprostol. The dose of which was 400 microgram up to 20 weeks gestation and 200 microgram thereafter, repeated every 4 hours with a 12 hours nightly rest from misoprostol application up to a maximum of 72 hours. Women having termination for similar reasons but lacking a history of cesarean section served as a control group.
Results:Abortion rate was 96.66% in the study group and 95% in the control group. The mean induction to abortion interval was 21.81±9.51 for the study group and 22.21±8.52 for the control group with no significant difference between the two groups. No cases of uterine rupture occurred in either groups.
Conclusion:Inducing abortion with lower misoprostol doses appear to be safe and effective throughout the second trimester in women with a single previous lower segment cesarean delivery.
Keywords :Second trimester, Misoprostol, Termination of pregnancy


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