Efficacy of misoprostol for medical termination of pregnancy in second trimester : Prospective study

Authors

  • Ouerdiane Nadia
  • Othmani Kaouther
  • Daaloul Walid
  • Ben Hamouda Sonia
  • Bouguerra Badreddine

Keywords:

Misoprostol, 2nd trimester abortion, scared uterus

Abstract

Aim: To investigate the efficacy of misoprostol used alone, and the time of fetal expulsion for medical termination of pregnancy in the second trimester. Patients and Methods: 50 patients were enrolled in a prospective study over two years and in whom termination of pregnancy was indicated between 14 and 28 weeks of amenorrhea. Misoprostol was reported in a well-defined protocol: group 1: 2 tablets every 3 hours as intra vaginal, group 2: half dose for women bull 4th or more or carrying a scarred uterus for terms greater than or equal to 22 weeks of amenorrhea.
Results: 48 patients expelled misoprostol alone and we have used an aspiration in two cases. The period of expulsion for 24 hours was 97% for the first group and 90% for the second.
Conclusion: using misoprostol within this protocol is effective and reduce the time required for the fetal expulsion of the secondtrimester pregnancy.

Downloads

Download data is not yet available.

References

P.C. Ho, P.D. B. lumenthal, K. Gemzell-Danielsson, R. Gómez Ponce de León, S. Mittal. Misoprostol for the termination of pregnancy with a live fetus at 13 to 26 weeks. International Journal of Gynecology and Obstetrics (2007) 99, S178-81

Uddin K, El-Refaey H, Soorana D, Stafforg M. Oral, Rectal and Vaginal. Pharmacokinetics of Misoprostol. Obstet Gynecol 2004; 30:866-70

Pongsatha S, Tongsong T. Intravaginal misoprostol for pregnancy termination. Int J Gynecol Obstet 2004; 87:176-7.

S. Hidar, M. Fekih, A. Chaïeb, M. Bibi, R. Mellouli, H. Khaïri. Apport de l'association d'ocytocine au misoprostol administré en intravaginal au cours des interruptions de grossesses entre 13 et 29 semaines d'aménorrhée : Essai clinique prospectif randomisé. J Gynecol Obstet Biol Reprod 2001 ; 30 : 439-43.

Nigam A, Singh VK, Prakash A. Vaginal vs. oral misoprostol for midtrimester abortion. Int J Gynecol Obstet 2006; 92:270-1.

Hoeffer PC, Ngai SW, Liu KL, Wong GC, Lee SW. Vaginal misoprostol compared with oral misoprostol in termination of second-trimester pregnancy.Obstet Gynecol 1997; 90: 735-8

Pak-chung HO, Suk Wai Ngai, Sharon WH, MBBS. Vaginal Misoprostol Compared With Oral Misoprostol in Termination of Second-Trimester Pregnancy. Obstet Gynecol 1997; 90:735-8.

Wong KS, Ngai CSW, Yeo ELK, Tang LCH, Ho PC. A comparison of two regimens of intravaginal misoprostol for termination of second trimester pregnancy: a randomized comparative trial. Hum Reprod 2000; 15:709-12.

Roel de Hens, Giuseppe CM, Gragiosi, Godelieve CML, Christians. Medical management for termination of second and third trimester pregnancies: a comparison of strategies. Eur J Obstet Gynecol 2004; 116:16-21.

Naz S, Sultana N. Role of misoprostol for therapeutic termination of pregnancy from 10-28 weeks of gestation. J Pak Med Assoc 2007;57:129-32.

Bhattacharyya SK, Mukherji J, Kamilya GS, Ray S, Hazra A. Two regimens of vaginal misoprostol in second trimester termination of pregnancy: a prospective randomised trial. Acta Obstet Gynecol Scand 2006; 85:1458-62.

Brouns JF, Van Wely M, Burger MP, Van Wijngaarden WJ. Comparison of two dose regimens of misoprostol for second-trimester pregnancy termination. Contraception 2010;82:266-75.

Cheng SY, Hsue CS, Hwang GH, Tsai LC, Pei SC. Hourly oral misoprostol administration for terminating midtrimester pregnancies: a pilot study. Taiwan J Obstet Gynecol. 2010 ;49:438-41.

Jain JK, Kuo J, Mishell DR. Comparison of two dosing regimens of intravaginal misoprostol for second-trimester pregnancy termination. Obstet Gynecol 1999; 93: 571-5.

A.-S. Weingertner, D. Hamid, J.-J. Baldauf, I. Nisand. Utilisations actuelles et potentielles de la mifépristone en gynécologie-obstétrique et dans les autres disciplines médicales. J Gynecol Obstet Biol Reprod 2004 ; 33 : 692-702

Hoffer MC, Charlier C, Giacalone PL, Zimbris L, Astruc M, Boulot P. Évaluation de l'association RU 486 - laminaires - misoprostol - anesthésie péridurale dans les interruptions médicales de grossesse des 2e et 3e trimestres. J Gynecol Obstet Biol Reprod 1998; 27: 83-6.

Josep Luis, Carbonell Estevea, Francisca Garcia Gallegob, Margardell Pérez Llorentea. Late second-trimester abortions induced with mifepristone, misoprostol and oxytocin: a report of 428 consecutive cases. Contraception 78 (2008) 52-60

Eng NS, Guan AC. Comparative study of vaginal misoprostol with gemeprost as an abortifiant in second trimester missed abortion. Aust NZJ Obstet Gynecol 1997; 37:331-4.

Daskalakis GJ, Mesogitis SA, Papantoniou NE, Moulopoulos GG, Papapanagiotou AA, Antsaklis AJ. Misoprostol for second trimester pregnancy termination in women with prior caesarean section. BJOG 2005; 112:97-9.

Bhattacharjee N, Ganguly RP, Saha SP. Misoprostol for termination of mid- trimester post caesarean pregnancy. Aust NZJ Obstet Gynecol 2007; 47:23-5.

Naguib AH, Morsi HM, Borg TF, Fayed ST, Hemeda HM. Vaginal misoprostol for second-trimester pregnancy termination after one previous cesarean delivery. Int J Gynaecol Obstet. 2010 Jan;108:48-51

Rouzi A. Second-trimester pregnancy termination with misoprostol in women with previous caesarean sections. Int J Gynecol Obstet 2003; 80:317-8.

Mazouni C, Provensal M, Porcu G, et al. Termination of pregnancy in patients with previous cesarean section. Contraception 2006; 73:244-8.

B. Letourneur, O. Parant, V. Tofani, A. Berrebi. Rupture utérine sur utérus sain au cours d'une interruption médicale de grossesse du 2e trimestre par misoprostol : À propos d'un cas traité de manière conservatrice. J Gynecol Obstet Biol Reprod 2002; 31: 371-373.

Downloads

Published

2015-08-19

Issue

Section

Original articles