Midtrimester abortion using vaginal misoprostol for women with three or more prior cesarean deliveries.
OBJECTIVE
To evaluate the safety and efficacy of vaginal misoprostol for second-trimester abortion in women with 3 or more prior cesarean deliveries.


METHODS
This study was conducted with 138 women who needed pregnancy termination between 13 and 26 gestational weeks, 31 with 3 or more previous cesarean deliveries and 107 with no uterine scars (the controls). Misoprostol was inserted in the vagina every 6 hours until regular contractions or products of conception appeared, a 200-microg tablet for the first 24 hours and 2 tablets thereafter. The outcomes assessed were successful vaginal abortion, hemorrhage requiring blood transfusion, incomplete abortion, and uterine rupture.


RESULTS
A vaginal abortion occurred in 28 women (90.3%) in the study group and 107 (100%) in the control group (P=0.01). There were no significant differences in the prevalence of the other assessed outcomes.


CONCLUSIONS
Vaginal misoprostol appears to be safe and acceptably effective for second-trimester pregnancy termination in women with 3 or more previous cesarean deliveries.
Fawzy
Muhammad
M
Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura, Egypt. mmfawzy@hotmail.com
Abdel-Hady
El-Said
el-S
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000028:Abortion, Induced / Q000379:methods*; D000282:Administration, Intravaginal; D000328:Adult; D016022:Case-Control Studies; D002585:Cesarean Section / Q000009:adverse effects; D002921:Cicatrix / Q000150:complications* / Q000209:etiology; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D016896:Treatment Outcome; D055815:Young Adult
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol