title: Misoprostol for midtrimester termination of pregnancy in women with 1 or more prior cesarean deliveries.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of vaginal misoprostol for midtrimester termination of pregnancy (TOP) in women with 1 or more prior cesarean deliveries (CDs).
  
  
  METHODS
  A retrospective study was conducted with 279 women undergoing TOP with vaginal misoprostol between 14 and 26 weeks of gestation. Of these, 193 had no uterine scars (group 1), 60 had 1 prior CD (group 2), and 26 had 2 or more prior CDs (group 3). The primary outcome was the success rate of TOP. Secondary outcomes were time from induction to abortion, total dose of misoprostol used, and occurrence of uterine rupture.
  
  
  RESULTS
  The success rates were 96.4% in group 1, 81.7% in group 2, and 76.9% in group 3 (P=0.001). Time from induction to abortion, total dose misoprostol, and duration of hospital stay differed significantly among the groups (P=0.001 for all variables). There were 3 cases (11.5%) of uterine rupture in group 3, for an overall rate of 1.1%.
  
  
  CONCLUSIONS
  Misoprostol inserted vaginally was effective for midtrimester TOP but the safety of using misoprostol in women with 2 or more prior CDs cannot be confirmed from the present study. Misoprostol should be used carefully, particularly in women with 2 or more prior CDs.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Cukurova University, Adana, Turkey. ukucukgoz@yahoo.com
authors.forename: Umran
authors.initials: U
authors.lastname: Küçükgöz Güleç
authors.forename: Ibrahim F
authors.initials: IF
authors.lastname: Urunsak
authors.forename: Esra
authors.initials: E
authors.lastname: Eser
authors.forename: Ahmet B
authors.initials: AB
authors.lastname: Guzel
authors.forename: Fatma T
authors.initials: FT
authors.lastname: Ozgunen
authors.forename: Ismail C
authors.initials: IC
authors.lastname: Evruke
authors.forename: Selim
authors.initials: S
authors.lastname: Buyukkurt
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage* / Q000009:adverse effects; D000028:Abortion, Induced / Q000379:methods*; D000282:Administration, Intravaginal; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000209:etiology / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014597:Uterine Rupture / Q000209:etiology; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol