Adequacy and safety of buccal misoprostol for cervical preparation prior to termination of second-trimester pregnancy.
OBJECTIVE
The objective of this retrospective, descriptive study is to assess the adequacy and safety of buccal misoprostol with and without laminaria for cervical preparation prior to second-trimester abortion.


METHODS
We analyzed Planned Parenthood Federation of America data from 2,218 elective dilation and evacuation (D&E) procedures conducted on women at 12 to 23 6/7 weeks of gestation from April 2002 to March 2003. Each woman received 400, 600 or 800 microg of buccal misoprostol with or without laminaria for preprocedural cervical preparation.


RESULTS
Of the patients, 62% received 400 mug, 32% received 600 microg and 6% received 800 microg of buccal misoprostol; 42.8% had laminaria inserted for phased cervical preparation. The adequacy of cervical dilation was 88.7%. The D&E procedure was completed during a single surgical procedure for 99.8%. The overall adverse event rate was 19.39 per 1,000 women, with a rate of 4.51 per 1,000 women for serious adverse events.


CONCLUSIONS
This descriptive study suggests that use of buccal misoprostol with or without laminaria is effective and safe. If buccal misoprostol eliminates or reduces the need for phased, multiday laminaria 1-3 days prior to the surgical procedure, then its use may offer service advantages such as reduced number of clinic visits and fewer pelvic examinations per woman.
Department of Obstetrics and Gynecology, John H. Stroger Jr. Hospital of Cook County, Chicago, IL 60612, USA. ashleshapatel16@yahoo.com
Ashlesha
A
Patel
Elizabeth
E
Talmont
Johanna
J
Morfesis
Murray
M
Pelta
Mary
M
Gatter
Michael R
MR
Momtaz
Harry
H
Piotrowski
Vanessa
V
Cullins
D000020:Abortifacient Agents, Nonsteroidal; D000028:Abortion, Induced / Q000009:adverse effects / Q000379:methods*; D000293:Adolescent; D000328:Adult; D002610:Cheek; D004107:Dilatation and Curettage; D005260:Female; D006801:Humans; D007795:Laminaria; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol