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Misoprostol for midtrimester termination of pregnancy in women with 1 or more prior cesarean deliveries
Author(s) -
Küçükgöz Güleç Ümran,
Urunsak Ibrahim F.,
Eser Esra,
Guzel Ahmet B.,
Ozgunen Fatma T.,
Evruke Ismail C.,
Buyukkurt Selim
Publication year - 2013
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2012.08.013
Subject(s) - misoprostol , medicine , obstetrics , uterine rupture , pregnancy , gestation , abortion , gynecology , labor induction , uterus , oxytocin , genetics , biology
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.