title: Placental retention in late first and second trimester pregnancy termination using misoprostol: a retrospective analysis.
abstract: OBJECTIVE
  Termination of pregnancy (TOP) for medical reasons is regularly performed using misoprostol. Presence of placental remnants followed by curettage, frequently complicate the procedure. Aim of this analysis is to audit our current policy for medical termination in late first and second trimester, looking at the management of third stage.
  
  
  METHODS
  A retrospective analysis of patient data was performed. Included were patients that underwent medical TOP in late first or second trimester. Patients were reviewed 6 weeks postdelivery. Characteristics of procedure, patient and pregnancy were analysed to determine factors associated with an increased risk of retained placenta/placental remnants.
  
  
  RESULTS
  We included 175 patients. Eighty-five patients (48%) underwent curettage immediately after delivery because of retained placenta or because placental remnants were suspected. Nineteen patients (11%) underwent curettage at later stage. All tissue was examined microscopically for confirmation of placental tissue. Analysis of characteristics of procedure, patients and pregnancies did not identify factors associated with an increased risk of retained placenta or placental remnants.
  
  
  CONCLUSIONS
  A large number of immediate and late curettages was seen after medical TOP. Misoprostol-dose might play a role and the role of ultrasonographic assessment of the uterine cavity immediately post-placenta-delivery needs to be studied.
authors: Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands.
authors: Bloeme J
authors: BJ
authors: van der Knoop
authors: Griet
authors: G
authors: Vandenberghe
authors: Antoinette C
authors: AC
authors: Bolte
authors: Attie T J I
authors: AT
authors: Go
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000028:Abortion, Induced / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D000465:Algorithms; D003475:Curettage / Q000706:statistics & numerical data; D004305:Dose-Response Relationship, Drug; D005260:Female; D005865:Gestational Age; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D010922:Placenta Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000601:surgery; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000187:drug effects; D011262:Pregnancy Trimester, Second / Q000187:drug effects; D012189:Retrospective Studies; D017211:Treatment Failure
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol