The use of vaginal misoprostol for second-trimester pregnancy termination in women with previous single cesarean section.
BACKGROUND
This retrospective study reports of 85 women in the second trimester with one prior cesarean section undergoing medical abortion of a viable unwanted pregnancy using vaginal misoprostol. Two regimens that were selected in a nonrandomized manner were used.


METHODS
Eighty-five women treated with vaginal misoprostol in a 3-year period were retrospectively analyzed. All received 400 mug of misoprostol initially and 22 (25.8%) aborted. Then Group A (n=43) received subsequent administration of 200 microg every 6 h, whereas Group B (n=20) received 400 microg/6 h.


RESULTS
All patients aborted. The groups had no statistical difference in mean age, gravidity, parity, gestational age, and time from previous cesarean section, and there was no difference in occurrence of side effects and mean induction to abortion time interval. The lower dosage group received a median of 600 microg of vaginal misoprostol (min 600 microg to max 1000 microg). There were no uterine ruptures, need for hysterotomy, or excess bleeding in any patient.


CONCLUSIONS
This is the largest series reported to date of second-trimester pregnancy termination in cases with one previous cesarean section using only vaginal misoprostol. The study shows that both used regimens are safe and equally effective. All 85 women aborted.
Daponte
Alexandros
A
Department of Obstetrics and Gynaecology, University Hospital of Larissa, University of Thessalia, Larissa 41110, Greece. dapontea@otenet.gr
Nzewenga
Guy
G
Dimopoulos
Konstantinos D
KD
Guidozzi
Franco
F
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage; D000028:Abortion, Induced / Q000379:methods*; D000282:Administration, Intravaginal; D000293:Adolescent; D000328:Adult; D002585:Cesarean Section; D004305:Dose-Response Relationship, Drug; D005260:Female; D005865:Gestational Age; D020073:Gravidity; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage*; D010298:Parity; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000187:drug effects*; D012189:Retrospective Studies; D016896:Treatment Outcome
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol