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

##plugins.themes.academic_pro.article.sidebar##

Published Aug 19, 2015
Download
pdf
Vol. 93 No. 4 (2015): Issue Apr 2015

##plugins.themes.academic_pro.article.main##

Ouerdiane Nadia
Othmani Kaouther
Daaloul Walid
Ben Hamouda Sonia
Bouguerra Badreddine

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.

Keywords:

Misoprostol, 2nd trimester abortion, scared uterus

##plugins.themes.academic_pro.article.details##

References

  1. 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
  2. Uddin K, El-Refaey H, Soorana D, Stafforg M. Oral, Rectal and Vaginal. Pharmacokinetics of Misoprostol. Obstet Gynecol 2004; 30:866-70
  3. Pongsatha S, Tongsong T. Intravaginal misoprostol for pregnancy termination. Int J Gynecol Obstet 2004; 87:176-7.
  4. 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.
  5. Nigam A, Singh VK, Prakash A. Vaginal vs. oral misoprostol for midtrimester abortion. Int J Gynecol Obstet 2006; 92:270-1.
  6. 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
  7. 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.
  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.
  9. 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.
  10. 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.
  11. 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.
  12. 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.
  13. 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.
  14. 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.
  15. 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
  16. 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.
  17. 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
  18. 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.
  19. 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.
  20. Bhattacharjee N, Ganguly RP, Saha SP. Misoprostol for termination of mid- trimester post caesarean pregnancy. Aust NZJ Obstet Gynecol 2007; 47:23-5.
  21. 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
  22. Rouzi A. Second-trimester pregnancy termination with misoprostol in women with previous caesarean sections. Int J Gynecol Obstet 2003; 80:317-8.
  23. Mazouni C, Provensal M, Porcu G, et al. Termination of pregnancy in patients with previous cesarean section. Contraception 2006; 73:244-8.
  24. 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.