Patients' obstetric history in mid-trimester termination of pregnancy with gemeprost: does it really matter?
OBJECTIVE
The objective was to investigate the importance of previous obstetric history for termination of pregnancy in the second-trimester with gemeprost alone.


METHODS
A consecutive series of 423 mid-trimester inductions of abortion at our teaching hospital was reviewed. Termination of pregnancy was carried out with 1mg of vaginal gemeprost every 3h up to three doses over a 24-h period, repeated the following day if necessary. Failed induction was defined as women undelivered by 96 h. The study population was then stratified by gestational age, parity, gravidity and previous uterine scars. Main outcome parameters were failed induction and complication rates. Statistical analysis was performed using the chi(2) test or Fisher's exact test for categorical data, and the t-test and linear regression for continuous variables.


RESULTS
No significant differences were found in the primary outcome parameters with regard to the obstetric parameters considered. The failed induction rate was 1.2% with an overall incidence of complications of 7.4%. Parity was the main factor that affected clinical response (time to abortion interval and number of pessaries).


CONCLUSIONS
Patients' obstetric history does affect the clinical response to gemeprost, but its safety and effectiveness are preserved. These data provide clinicians with important information for correct counselling.
Scioscia
Marco
M
Department of Obstetrics and Gynaecology, University of Bari, Policlinico di Bari, Piazza Giulio Cesare 11, 70125 Bari, Italy. marco.scioscia@tin.it
Vimercati
Antonella
A
Pontrelli
Giovanni
G
Nappi
Luigi
L
Selvaggi
Luigi
L
D000020:Abortifacient Agents, Nonsteroidal / Q000009:adverse effects*; D000028:Abortion, Induced / Q000009:adverse effects*; D000282:Administration, Intravaginal; D000328:Adult; D000527:Alprostadil / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D005865:Gestational Age; D006801:Humans; D010298:Parity; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000187:drug effects; D011262:Pregnancy Trimester, Second / Q000187:drug effects; D012189:Retrospective Studies; D012307:Risk Factors; D014599:Uterus / Q000002:abnormalities
D000020:Abortifacient Agents, Nonsteroidal; C021182:gemeprost; D000527:Alprostadil