Intravaginal gemeprost and second-trimester pregnancy termination in the scarred uterus.
OBJECTIVE
To investigate the effectiveness and complication rate of intravaginal gemeprost, a prostaglandin E(1) analogue, for second-trimester pregnancy termination in women with a scarred uterus.


METHODS
Of 439 women undergoing induced abortion between the 13th and the 23rd week of pregnancy, 67 had a scarred uterus because of 1 or more cesarean sections or myomectomy. All women received a 1 mg dose of gemeprost intravaginally every 3 h, up to 5 times over 24 h. Those who did not respond received further cycles of gemeprost treatment.


RESULTS
The rate of successful abortions among women with uterine scars was not different from that observed in the nulliparous controls, but previously vaginal delivery was associated with a shorter induction to abortion interval. The rate of severe complications did not differ between the groups, and was about 1%.


CONCLUSIONS
The rate of complications following intravaginal administration of a PGE(1) analogue for second-trimester pregnancy termination was similar in women with a scarred or unscarred uterus.
Marinoni
E
E
Laboratory of Perinatal Medicine and Molecular Biology, Department of Gynecology, Perinatology and Child Health, University La Sapienza, Rome, Italy. emanuelamarinoni@hotmail.com <emanuelamarinoni@hotmail.com>
Santoro
M
M
Vitagliano
M P
MP
Patella
A
A
Cosmi
E V
EV
Di Iorio
R
R
D000028:Abortion, Induced; D000282:Administration, Intravaginal; D000328:Adult; D000527:Alprostadil / Q000008:administration & dosage / Q000031:analogs & derivatives*; D002585:Cesarean Section; D002921:Cicatrix / Q000150:complications; D005260:Female; D005315:Fetal Diseases / Q000601:surgery; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011459:Prostaglandins E, Synthetic / Q000008:administration & dosage*; D012189:Retrospective Studies; D014597:Uterine Rupture / Q000517:prevention & control
D011459:Prostaglandins E, Synthetic; C021182:gemeprost; D000527:Alprostadil