Misoprostol for Termination of Second Trimester Pregnancy
Introductions: The termination of second trimester pregnancy is challengingÂ due unfavorable cervix. This study evaluate the efficacy and maternal sideÂ effects of intravaginal misoprostol for termination of second trimesterÂ pregnancy.
Methods: During one year period from 15th June 2011 to 14th June 2012,
Department of Obstetrics and Gynaecology of Patan Hospital, women admittedÂ for second trimester termination of pregnancy for fetal congenital anomaliesÂ and intrauterine fetal demise were studied using the International FederationÂ of Gynaecology and Obstetrics recommended doses of vaginal misoprostol.Â For congenital anomalies, 400 mcg 3 hourly to a maximum of 5 doses wereÂ used. For fetal demise, gestational age of 13-17 weeks received 200 mcg everyÂ 6 hourly to a maximum of 4 doses, and 18-26 weeks dose was adjusted toÂ 100 mcg. Main outcome measures included success rate of abortion within 48Â hours, induction to delivery interval and maternal side effects.
Results: There were 40 patients during study period. Success rate for terminationÂ of 2nd trimester pregnancy within 48 hours was 88.8% for congenital anomalies.Â For fetal demise, success of termination was 90.9% at 13-17 weeks and 100%Â at 18-26 weeks. Median time from induction to delivery was 26.8 hours forÂ congenital anomalies. For fetal demise, it was 18 hours for 13-17 weeks wasÂ and 24 hours at 18 to 26 weeks respectively. Abdominal pain was seen in allÂ doses of misoprostol.
Conclusions: Vaginal misoprostol is an effective method for termination of
second trimester pregnancy.
Keywords: misoprostol, pregnancy, second trimester termination