Misoprostol in second and early third trimester for termination of pregnancies with fetal anomalies.
OBJECTIVE
To assess the effectiveness of a prostaglandin E1 analog, misoprostol, using different regimens compared with dinoprostone in termination of pregnancies in second and early third trimester complicated by either congenital fetal anomalies or intrauterine fetal demise.


METHODS
A retrospective review of 59 pregnancies between 15 and 30 weeks was performed which were terminated due to congenital fetal anomalies or intrauterine fetal demise. In group 1 (n=29) 400 microg oral and 600 microg vaginal misoprostol, in group 2 (n=12) 600 microg vaginal misoprostol and in group 3 (n=18) 0.5 mg dinoprostone gel were given for the termination of the pregnancies. All these groups were evaluated for demographic characteristics and delivery findings. Statistical analysis were performed by one-way ANOVA, Kruskal-Wallis and chi(2)-test.


RESULTS
No significant statistical difference was observed in terms of age, gravidity, parity, previous abortion, gestational week, frequency of prostaglandin usage, and birth weights among the three groups. The time intervals between the first administration and delivery were 20.3 h for oral vaginal misoprostol, 17.3 h for vaginal misoprostol and 22.5 h for the dinoprostone group (P=0.594). Evacuation rates after single doses were similar in all groups (83%, 73% and 72%, respectively). Uterine tachysystole was the only major side effect encountered in the oral-vaginal misoprostol group.


CONCLUSIONS
All three regimens yielded similar results for termination of pregnancies in second and third trimester. The major advantage of misoprostol was the cost.
Mendilcioglu
I
I
Department of Obstetrics and Gynecology, School of Medicine, Akdeniz University, Antalya, Turkey. imendilcioglu@hotmail.com
Simsek
M
M
Seker
P E
PE
Erbay
O
O
Zorlu
C G
CG
Trak
B
B
D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use*; D000028:Abortion, Induced / Q000379:methods*; D000282:Administration, Intravaginal; D000284:Administration, Oral; D000328:Adult; D015232:Dinoprostone / Q000627:therapeutic use*; D005260:Female; D005313:Fetal Death; D005333:Fetus / Q000002:abnormalities; D006801:Humans; D007751:Labor, Induced / Q000379:methods; D016595:Misoprostol / Q000627:therapeutic use*; D010120:Oxytocics / Q000627:therapeutic use*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D012189:Retrospective Studies
D000020:Abortifacient Agents, Nonsteroidal; D010120:Oxytocics; D016595:Misoprostol; D015232:Dinoprostone